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The formation of a mastoid cavity by removal of the canal wall is the simplest and most effective procedure for facilitating the removal of cholesteatoma, but may bestow the most lasting infirmity due to loss of ear function upon the patient treated in this way. The following strategies are employed to mitigate the effects of canal wall removal:
A mastoidectomy is a procedure performed to remove the mastoid air cells [1] near the middle ear. The procedure is part of the treatment for mastoiditis, chronic suppurative otitis media or cholesteatoma. [2] Additionally, it is sometimes performed as part of other procedures, such as cochlear implants, [3] or to access the middle ear.
Tympanoplasty is the surgical technique of removal of the retracted area from the middle ear and reconstruction of the tympanic membrane. Some surgeons use cartilage (taken from the outer ear) to stiffen the eardrum with the aim of preventing further retraction. [9] Surgical removal is required once a cholesteatoma has formed.
Prussak's space is important because it is a site for pars flaccida acquired cholesteatoma formation. [5] A cholesteatoma forms when there is a deep retraction pocket in the tympanic membrane. The lining of the tympanic membrane, which is skin, is shed, but if the membrane is retracted it gets trapped.
Some mastoiditis is caused by cholesteatoma, which is a sac of keratinizing squamous epithelium in the middle ear that usually results from repeated middle-ear infections. If left untreated, the cholesteatoma can erode into the mastoid process, producing mastoiditis, as well as other complications.
Otology and neurotology encompass more complex surgery of the inner ear not typically performed by general otolaryngologists, such as removal of vestibular schwannoma, cholesteatoma, labyrinthectomy, surgery of the endolymphatic sac for Ménière's disease and cochlear implant surgery.
Depending on length of symptoms, multinucleated giant cells and calcifications may be seen. Other disorders may be concurrently present, especially since this is a post infectious/inflammatory disorder, and these include a cholesterol granuloma, "tunnel clusters" (glandular epithelial inclusions below the surface epithelium), and cholesteatoma.
Koerner's septum is an anatomic boundary in the temporal bone formed by the petrosquamous suture between the petrous and squamosal portions of the mastoid air cells, at the anatomic level of the mastoid antrum. [1]