Canal walldown procedure with soft posterior meatal wall reconstruction in acquired cholesteatoma: focus on postoperative middle ear status After the ear canal is packed, the fascia is gently pulled laterally and adapted to the canal wall, Posterior meatal wall of ear it as far laterally as possible, so that the posterior ear canal skin flap can cover it from the meatal side (Fig.
820). Communication between the tympanic cavity and the mastoid cavity is thus secured, allowing removal of the Gelfoam In canal wall down (CWD) mastoidectomy procedure, the posterior meatal wall (PMW) is removed providing exposure of the entire attic and middle ear, helping to ensure complete disease eradication.
So the recurrence rate is as low as 2 in Mastoid obliteration combined with softwall reconstruction of posterior ear canal. Mastoid obliteration with bone powder in combination with softwall reconstruction of the posterior ear canal appeared a useful method for obliterating mastoidectomized cavity especially for prevention of postoperative pocket formation.
Murata K (1994 Even if postoperative middle ear aeration is disturbed, a retraction pocket may not be expected to occur easily in ears with a soft posterior meatal wall, because of its flexibility compared to ears with a usual hard posterior meatal wall. The human ear canal is divided into two parts. The elastic cartilage part forms the outer third of the canal; its anterior and lower wall are cartilaginous, whereas its superior and back wall are fibrous.
Tachibana, Tomoyasu Kariya, Shin Orita, Yorihisa Nakada, Michihiro Makino, Takuma Komatsubara, Yasutoshi Matsuyama, Yuko Naoi, Yuto and Nishizaki, Kazunori 2018. Canal walldown procedure with soft posterior meatal wall reconstruction in acquired cholesteatoma: focus on postoperative middle ear May 21, 2018 The surgeon should be careful to avoid extensive posterior cyst wall resection because floppy ear deformities can result. No significant recurrence is associated with complete excision of ICC Kimura disease Dec 28, 2010 Radical Mastoidectomy is a procedure to eradicate disease from the middle ear and mastoid without any attempt to reconstruct hearing.
Posterior meatal wall The posterior meatal skin including the subepithelial tissue is removed and replaced by spitthickness skin grafts from the backside of the auricle after widening the ear canal by drilling in all possible directions.
If the meatal skin can be reused after resecting the subepithelial tissue and the aspect of the epithelium appears fairly normal The posterior meatal wall was removed and reconstructed during the same operation, following cleansing of the middleear cavity and ossiculoplasty.
Either autograft bone (previously removed from the meatal wall) or homograft Feb 15, 2018 The periosteum is elevated forward as far as the lateral end of the posterior bony meatal wall, backward for a few millimeters, and upward (simultaneously pushing up the temporalis muscle) to the level of the upper attachment of the pinna.