Download Cholesteatoma and Anterior Tympanotomy by Tamotsu Morimitsu PDF

By Tamotsu Morimitsu

Acquired aural cholesteatoma poses a special procedural issue with reference to pathogenetic study and thought construction. simply because cholesteatoma spontane­ ously happens basically within the poorly pneumatized human ear, its pathogenesis is restricted to people. still, due to the moral questions surrounding human experimentation, pathogenetic examine has virtually solely concerned nonhuman matters. certainly, makes an attempt have failed in just about all animal expe­ riments other than with the gerbil, or even the following experimental designs were unbelievable in comparison with human cholesteatoma. Cholesteatoma within the gerbil comes in handy, hence, just for the learn of pathology and never for human pathogenesis. I carry that the pathogenesis of cholesteatoma could be understood through learning the cholesteatomatous ear, that's, the malpneumatized ear of the human. The anatomical distinction among the traditional and malpneumatized ear is a possible reason behind cholesteatoma. This distinction might be discovered clinically in facial nerve decompression and cholesteatoma surgical procedure, as, for instance, facial nerve palsy happens frequently within the general, well-pneumatized ear. after all, traditional animal experimentation won't verify this scientific distinction seeing that there isn't any perfect animal version for the poorly pneumatized human ear. current surgical concepts for cholesteatoma fluctuate significantly in line with indi­ vidual otosurgeon's opinion. the main severe distinction of opinion is targeted on even if to take away the exterior ear canal wall. in general, the most suitable choice will be to not eliminate the canal wall if cholesteatoma recurrence will be avoided. easily positioned, recurrence of cholesteatoma comes approximately whilst its reason has no longer been got rid of in the course of fundamental surgery.

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Extra info for Cholesteatoma and Anterior Tympanotomy

Sample text

2-27c) was covered with simple squamous epithelium with microvilli. Its lamina propria consisted of pseudo-stratified fibrocysts with loose collagenous fibers. In this fold were found scattered amyelinated nerve fibers (Fig. 2-27d), thought to be free axon ending, although neither mitochondria nor secretory granules were present. The blood vessels (Fig. 2-27e) had nonfenestrated endothelium and were partially covered with pericytes. 2 Pathological Mucosal Fold Figure 2-28 presents mucosal folds in contact with the perimatrix of cholesteatoma.

Anterior tympanotomy is a surgical technique used always in combination with intact canal wall mastoidectomy in surgery for cholesteatoma. It was not originally a technique for eradication of the cholesteatoma matrix membrane but rather for improvement of intratympanic ventilation from the eustachian tube. Ocm toward the preauricular helical crus (Fig. 3-1, large arrow). The upper two-thirds of the auricle is detached anteriorly and inferiorly at the layer close to the auricular perichondrium. Then a large triangular flap (PaIva's flap, P) is detached from the planum mastoideum, together with its periosteum, to the zygomatic root (Z) and passing over the external ear canal.

2-18). 2 Shape of the Supratubal Recess The shape of the supratubal recess (STR) was classified into three categories: underdeveloped STR (27 bones in which upward extension of the STR did not Ears 25 20 15 10 5 o pretenn full tenn lW - lav1 1-2Y 3-10Y Age groups FIG. 2-18. Relationships among five age groups and their grades of pneumatization: age groups preterm, full term, 1 week-12 months, 1-2 years, or 3-10 years with grades of pneumatization - (black bars), :±: (stippled bars), or + (white bars) 26 2.

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