METHOD OF CLOSED TYMPANOPLASTY FOR PATHOLOGICAL EPIDERMIZATION OF TYMPAN CAVITY Russian patent published in 2023 - IPC A61F11/20 A61B17/00 A61F2/18 

FIELD: medicine; otorhinolaryngology.

SUBSTANCE: middle ear is sanitized and defects in the mucous membrane are restored by forming a layer of a covering element on the walls of the tympanic cavity in the form of a gasket made of polymer material. The gasket is cut to the size of the medial wall of the tympanic cavity, then myringoplasty is performed. Surgical intervention is carried out in two stages. The first step is to place the gasket. The gasket is made with dimensions: thickness of 0.2 mm, length of 11.0 mm, width of 8.6 mm. The gasket shape is obtained based on the following anatomical measurements: the distance between the oval and round window; longitudinal and transverse dimensions of the oval window; the distance between the round window and the spoon-shaped process; the distance between the anterior edge of the oval window and the spoon-shaped process; width of the tympanic anastomosis of the auditory tube in the protympanum projection; the distance between the round window and the most distant point of the canal of the tensor tympani muscle; the distance between the round window and the upper wall of the tympanic cavity at the point of its projection of the spoon-shaped process; the distance between the posterior wall of the tympanic cavity in the tympanic sinus and the point of the bone tympanic ring, corresponding to the projection of the middle of the tympanic orifice of the auditory tube. The gasket corresponds to the images, as shown in Fig. 1 and 2. If the stapes superstructures are preserved, the gasket is cut out in accordance with Fig. 1. The gasket covers the tympanic orifice of the auditory tube, the hemicanal of the tensor tympani muscle, the promontory of the tympanic cavity, the spoon-shaped process, the area of the medial wall of the tympanic cavity between the oval window niche and the spoon-shaped process, the round window niche, and the sinuses of the retrotympanum. If the stapes superstructures are lost, the spacer is cut out in accordance with Fig. 2. The gasket also covers the niche of the oval window. At the second stage of surgical intervention, no earlier than 6 months later, the lining is removed from the tympanic cavity and the chain of auditory ossicles is reconstructed.

EFFECT: method allows to improve the functional results of tympanoplasty in the long term by preventing the development of a cicatricial adhesive process in the tympanic cavity due to the barrier between the inner and outer walls of the tympanic cavity.

3 cl, 4 dwg, 2 ex