METHOD FOR INCREASING VOLUME OF TYMPANIC CAVITY IN SURGICAL TREATMENT OF PATIENTS WITH CHRONIC PURULENT OTITIS MEDIA Russian patent published in 2022 - IPC A61F11/00 A61B6/03 A61B34/20 

FIELD: medicine; otorhinolaryngology.

SUBSTANCE: before surgery, computer tomography of the temporal bone is carried out for a patient, obtained data is entered to an electromagnetic navigation system. A sensor of the electromagnetic navigation system is installed in the oral cavity from the side of the operated ear. The navigation system is set in accordance with preliminary entered data of computer tomography of the temporal bone of the patient. Then, a sanitizing part of the surgery is performed through behind-the-ear approach and next with transmastoid and endoural access: attico-, antro-, and mastoidotomy with sanitation of middle ear cavities. The tympanic cavity is revised, its size and degree of distribution of inflammatory and cholesteatomic processes are determined. After that, under control of the navigation system, a diamond drill is used to smooth the cochlear process, the bone wall between the auditory tube and the semi-canal of the muscle straining the tympanic membrane. The bone canopy over the tympanal mouth of the auditory tube is thinned from the side of the tympanic cavity for 2 mm or before the appearance of the muscle straining the tympanic membrane. Next, Cog is removed with opening of the epitympanal sinus. Next, the bone wall is thinned downward from the auditory tube for 2 mm along the projection of the canal of the internal carotid artery to the bulb of the jugular vein, as well as from the pyramidal process downward towards the hypotympanum. Ponti cuius, subiculum funiculus is thinned. Scutum is smoothed so that a distance from the medial wall of the hypotympanum to a level of the tympanic ring is at least 5 mm. At the final stage of the surgery, the sound-conducting system of the middle ear is reconstructed. In the end of the surgery, the external auditory canal is tamponed with hemostatic sponges. The postoperative wound is sutured layer-by-layer.

EFFECT: method allows for an increase in the safety of surgical intervention on the middle ear, improvement of a sanitizing and reconstructive result of a surgery due to creation of conditions for better visualization and full aeration of all sections of the tympanic cavity and elimination of its “narrow” sites, which, in general, provides prevention of recurrence of cholesteatoma and scar obliteration of the postoperative cavity.

1 cl, 2 ex