METHOD OF SURGICAL REMOVAL OF FORMATION OF APEX OF TEMPORAL BONE PYRAMID Russian patent published in 2023 - IPC A61F11/20 A61B17/00 A61F2/18 

FIELD: medicine; otorhinolaryngology.

SUBSTANCE: formation of the apex of the temporal bone pyramid is removed using a modified transcanal infrapromontorial approach. At the first stage, the skin of the walls of the external auditory canal is separated with elevation and removal of the meatotympanic flap to the level of the cartilaginous part of the external auditory canal. The autocartilage of the medial surface of the auricle and the autofascia of the temporal muscle are collected. At the second stage, wide canaloplasty is performed to the level of the central cells of the facial nerve canal in the mastoid region. The lower wall of the external auditory canal (EA) is removed along with the tympanic ring to the level of the jugular vein bulb. The anterior wall of the joint is smoothed without opening the temporomandibular joint. At the third stage, skeletonization of the internal carotid artery (ICA) is performed in the vertical section and the knee area. Then the pericarotid cells, hypotympanum cells, and infralabyrinthine cell space are opened. The bone capsule of the basal curl of the cochlea is thinned. Afterwards the ICA is decanalized, mobilized and shifted anteriorly. At the fourth stage, the formation of the apex of the pyramid of the temporal bone is removed, followed by visualization, sanitation and revision of hard-to-reach areas of the apex of the pyramid and the area of the knee of the ICA, its anterior and medial walls, and the area of the anterior wall of the internal auditory canal. At the fifth stage, hemostatic material is placed in the postoperative cavity, a fragment of autocartilage is placed in the infrapromontorial space, completely covering the ICA, and autofascia is placed on the handle of the malleus using the underlay technique. The preserved NSP skin is laid over the fascia.

EFFECT: method allows to preserve the function of the facial nerve, as well as auditory function during surgical treatment of isolated lesions of the apex of the temporal bone.

1 cl, 15 dwg, 1 ex