Mastoidectomy Facial Recess Approach and Cochleostomy Techniques

Facial Nerve Recess Cochlear Implant

The important point in considering the mastoidect-omy for placement of a cochlear implant is that this is much smaller than that utilized for chronic ear disease. In contrast to the standard method of saucerizing the mastoid cavity, this is not performed in cochlear implant surgery. There are two areas that need to be skeletonized, and the single most important one of these is the bony external auditory canal. If the bony external auditory canal is not thinned appropriately, then the angle...

Considerations in Graft Healing

The normal tympanic membrane has a complex layered structure consisting of thin stratified squamous epithelium on the lateral surface, flat respiratory epithelium on the medial surface, and two fibrous layers, one radial and one longitudinal, between the two epithelial layers. The fibrous layers also contain vascular elements. successful, functional repair of the tympanic membrane requires reconstitution of the epithelial layers and enough of a fibrous middle layer to provide satisfactory...

Maintaining the Middle Ear Space

Once the reconstruction is complete, one must take the necessary steps to maintain a good reconstruction. The first step is the maintenance of an air-containing middle ear space during the immediate healing period. There are many options for maintaining this space. By far the most popular in the United States is the use of Gelfoam or Gelfilm. Gelfoam is a cellulose-based foam that is thought to be enzymatically degraded in 50 to 60 days by the middle ear. Major benefits are its easy insertion...