Surgical debridement method of congenital cholesteatoma of anterior mesotympanum

Abstract

The article presents a debridement method of congenital cholesteatoma of the tympanic cavity, typically located in the anterior part of the mesotympanum. In this method, the meatotympanic flap is formed by separating the skin of the external auditory canal from 8 to 4 hours. Next, the tympanic cavity is opened, the tympanic membrane is separated from the handle of the malleus, starting from its short process, from top to bottom, maintaining contact in the umbo area. Then, the anterior malleus fold is dissected with a microneedle, the anterior-upper part of the bone tympanic ring is removed with a burr until the congenital cholesteatoma is fully visualized. After that, the capsule of congenital cholesteatoma is separated from the medial surface of the tympanic membrane, after which it is removed. This method allows reducing the risk of developing residual and recurrent cholesteatoma and at the same time preserving the anatomical integrity of the structures of the middle ear and the patient’s hearing.