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Cholesteatoma of the left ear
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| 1. Otoscopic control before starting the procedure. View of the stapes footplate through a peripheral perforation. Above of the footplate runs the facial nerve (right side of the picture). | 2. Otoscopic control before starting the procedure. View of the cholesteatoma above the facial nerve. |
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| 3. Retroauricular incision, elevation of the skin of the posterior wall of the external auditory canal, and placement of a retractor. | 4. Enlarging the posterior wall of the external auditory canal. |
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| 5. Enlargement of the superior wall (epitympanic area). | 6. Identification of the sac of the cholesteatoma. |
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| 7. Revealing, gradually, the cholesteatoma following the sac towards the anterior epitympanum and the antrum. | 8. Trying to identify the borders of the cholesteatoma in the anterior epitympanic recess. |
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| 9. Trying to identify the borders of the cholesteatoma in the area of the antrum. | 10. Expanding the antrotomy and identification of the posterior limit of the cholesteatoma. |
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| 11. Completion of the epitympanotomy and identification of the anterior and the superior limit of the cholesteatoma. | 12. Elevation of the cholesteatoma with a round knife from the area of the antrum. |
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| 13. Elevating the cholesteatoma from the anterior epitympanum. The malleus head is observed. | 14. Removing the cholesteatoma from the tympanic cavity. |
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| 15. The cholesteatoma after its complete removal. | 16. Cutting the tendon of the tensor tympani muscle with tympanoplasty scissors. |
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| 17. Cutting the malleus neck and removal of its head. | 18. Removing adhesions from the stapes footplate and checking its mobility. |
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| 19. Elevation of the remnant of the tympanic membrane. | 20. Receiving a chondral-perichondrium graft from the concha of the auricle. |
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| 21. Receiving temporalis fascia as additional graft. | 22. Insertion of an acoustic prosthesis (TORP). |
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| 23. Placement of the chondral-perichondrium graft over the acoustic prosthesis. | 24. Covering the operative cavity with the temporalis fascia graft. |
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| 25. Packing the cavity with absorbable material. | 26. Canaplasty and wound closure. |
