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Chronic suppurative otitis media with and without cholesteatoma Hongyan  Jiang  MD&PhD Otorhinolaryngology Hospital,The First Affiliated Hospital of Sun Yat-sen University
Chronic suppurative otitis media without cholesteatoma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chronic suppurative otitis media without cholesteatoma ,[object Object],[object Object]
Near Total TM Perforation
Cholesteatoma
Cholesteatoma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cholesteatoma
Cholesteatoma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Congenital cholesteatoma ,[object Object],[object Object],[object Object],[object Object]
Acquired Cholesteatoma ,[object Object],[object Object],[object Object],[object Object],[object Object]
Primary acquired cholesteatoma ,[object Object],[object Object],[object Object],Normal TM Mucoid effusion and primary acquired cholesteatoma Mesotympanic cholesteatoma
Primary acquired cholesteatoma
Secondary Acquired Cholesteatoma ,[object Object],[object Object],[object Object]
COM with and without cholesteatoma Diagnosis
COM with and without cholesteatoma Diagnosis ,[object Object],Axial Section Coronal Section
Cholesteatoma Imaging
Cholesteatoma Imaging
COM with and without Cholesteatoma Treatment
Chronic suppurative otitis media  without  cholesteatoma ,[object Object],[object Object],[object Object]
Ototopical Medications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Tympanoplasty ,[object Object],[object Object],[object Object]
Underlay Tympanoplasty
Ossicular Chain Reconstruction
Chronic suppurative otitis media  with  cholesteatoma ,[object Object],[object Object],[object Object],[object Object]
Mastoidectomy ,[object Object],[object Object],[object Object],[object Object]
Mastoidectomy Tympanoplasty with mastoidectomy and hydroxyapatite bone cement ossicular reconstruction
Surgical  development radical mastoidectomy (canal wall-down ,CWD) modified radical mastoidectomy close mastoidectomy(canal wall-UP ,CWU) modified close mastoidectomy Mastoid obliteration   soft/hard canal-wall reconstruction endoscopic middle ear surgery endoscope-assisted surgery of middle ear
a: atticotomy; b:bridge; o: otosclerosis drilling;  e: thin posterior bony ear canal wall;  cm:  cortical mastoidectomy ;  aa  :anterior attic,  hc :horizontal semicircular canal;  ib:  incus body;  mh : malleus head;  m:  malleus;  f:  facial canal;  r : round window;  c :  chorda;  s : tympanic sinus Tos 改良完壁式乳突根治   Tos modified  close  mastoidectomy
HongKong Flap Hung T ,et al.  Laryngoscope 2007;117:1403-1407
Postauricular periosteal-pericranial flap Ramsey MJ ,et al.  Otol Neurotol. 2004 Nov;25(6):873-8
Middle temporal artery flap Singh V, et al.  Otolaryngology–Head and Neck Surgery (2007) 137, 433-438
Soft canal-wall reconstruction Takahashi H , et al.  Eur Arch Otorhinolaryngol (2007) 264:867
endoscopic middle ear surgery
 
 
Surgical  development radical mastoidectomy (canal wall-down ,CWD) classic radical mastoidectomy  modified radical mastoidectomy close mastoidectomy(canal wall-UP ,CWU) modified close mastoidectomy Mastoid obliteration   soft/hard canal-wall reconstruction endoscopic middle ear surgery endoscope-assisted surgery of middle ear
COM with and without Cholesteatoma Complications
Complications of Otitis Media ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],Complications of Otitis Media
Acute mastoiditis with sub-periosteal abscess
Brain Abscess
Complications of Otitis Media ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Summary ,[object Object],[object Object],[object Object],[object Object]
Thanks for your attention!

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7 chronic suppurative otitis media with and without cholesteatoma

Notes de l'éditeur

  1. These more severe perforations. The middle ear structures can be easily seen. Note the malleus handle, umbo, incudostapedial joint, stapedius muscle, stapes in the oval window, and round window. A perforation of this size is likely to require surgical repair.
  2. Infection in the mastoid has eroded through the mastoid cortex forming a “subperiosteal abscess.” This condition requires antibiotics and surgical drainage.