Middle Ear Malformation: Endoscopic Ossiculoplasty

By June 7, 2019

Reyes, Joaquin1; Haeffeli, Ignacio2; Prieu, Fernando2; Stipech, Guillermo3
1 Otologic surgeon, Hospital Univalle, Cochabamba, Bolivia;
2 Otologic surgeon , Hospital Iturraspe, Santa Fe, Argentina;
3 Otologic surgeon, Clinica Godoy Cruz, Mendoza, Argentina.

in view of the need to restore hearing in patients with defects of the middle ear in the second half of the 20th century, infinity of techniques for the reconstruction of ossicular mechanics emerge, most of the techniques described require retro-auricular approaches even the need to perform canalplasty to expand the exposure of the tympanic cavity. As technology advanced, transcanal endoscopic approaches began to be described and the use of this surgical tool is proving to be useful avoiding unnecessary mastoidectomies. The main objective of this study is to demonstrate a wide exploration of the middle ear with bone malformation and reconnection of ossicular chain performed by transcanal approach without the need for canalplasty.

 case report, chronic otitis media with bone neo formation in tympanic cavity
Intervention: patient with long-standing left hearing loss, referring  tympanic perforation of years of evolution, tonal audiometry was performed,  showing moderate conductive hearing loss in the left ear middle air bone gap of 40 dB, computed tomography was performed showing osseous tissue occupying partially protympanum  and anterior epitimpanic space medial to the ossicular chain. the otomicroscopy revealed middle central tympanic perforation in the left ear. underwent type 3 tympanoplasty  with ossicular chain reconstruction with autologous incus

Main Outcome Measure: successful tympanic membrane closure with satisfactory auditory improvement for the patient
Results: tympanic membrane closureaverage air bone GAP 15dB
Conclusions: the endoscopic approach for pathologies of the tympanic cavity allows greater exposure than the conventional, avoiding transmastoid accessory portals and can be performed even in narrow external auditory canals without the need to dilate them
Additional information: case report