METHOD TO PERFORM MASTOIDOPLASTY Russian patent published in 2024 - IPC A61F11/20 A61B17/00 A61F2/18 A61F13/53 

FIELD: medicine; otorhinolaryngology.

SUBSTANCE: bone stage of the Zaufal-Levin operation is performed: the cholesteatoma is removed. The cells of the mastoid process of the temporal bone, including the apical ones, affected by cholesteatoma are removed, forming a common cavity consisting of the tympanic and trepanation segments. It is revised, and if it is affected by the carious process, the incus, head of the malleus, and superstructures of the stapes are removed. The tympanic orifice of the auditory tube is inspected. Ossiculoplasty is performed. A graft is placed to replace the defect of the tympanic membrane, forming a neotympanic membrane. Before cholesteatoma is removed, a facial nerve monitoring system is installed on the facial muscles. A postauricular approach is performed and a combined transmeatal-transcortical route is used. After revision of the tympanic opening of the auditory tube, under the control of the facial nerve monitoring system, the posterior bone wall of the external auditory canal is removed from the horizontal level passing through the lower point of the lumen of the bony external auditory canal from below to the temporal line from above. The bone is removed until the thickness of the bone mass covering the facial nerve canal reaches 1.0 mm. After the formation of the neotympanic membrane, the lower part of the trepanation segment, corresponding to the apical group of mastoid cells, is filled with fragments of Sergicel material measuring 0.5×0.5×0.2 cm. The Sergisel material is laid in layers, raising the lower border of the trepanation segment to a horizontal level passing through the lower point of the lumen of the bony external auditory canal, leaving the higher part of the trephination segment free. Then the general cavity is tamponed with absorbable material, meatoplasty is performed, and sutures are placed on the skin incision.

EFFECT: method allows to increase the efficiency of surgical treatment and subsequent rehabilitation of patients with chronic purulent epitympanoantral otitis media.

4 cl, 2 dwg, 1 ex