Dallas Ear Institute
7777 Forest Lane, Suite A-103, Dallas, TX 75230 | Phone: (972) 566-7600 | Fax: (972) 566-6560 | www.dallasear.com

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2nd look procedure for Middle Ear Cholesteatoma Case Number 2

1. View of eardrum and cartilage graft.  Patient had a history of extensive cholesteatoma with significant erosion of the ear canal wall and ossicular chain.  The cholesteatoma was removed on the primary surgery and the ear canal bone was reconstructed with a cartilage graft (black arrow).  This cartilage is taken from the patient’s own ear and is used to rebuild the ear canal and prevent the eardrum skin from retracting into the mastoid cavity.  The white arrow is pointing towards the eardrum and the middle ear space.  There does not appear to be any retraction, or sucking in, of the new eardrum reconstruction.

2. The eardrum has been lifted up with an incision through the ear canal.  The black arrow indicates the cartilage graft that was used during the primary surgery.  This has completely integrated with the repair.  The white arrow indicates the area that was completely filled with cholesteatoma during the first surgery and is now free of any disease.  The blue arrow is pointing toward Silastic sheets that had been placed in the middle ear cavity to prevent scar formation during the healing period. 

3. The Silastic sheets have been removed from the middle ear cavity, and a prosthesis is placed from the footplate of the inner ear to the undersurface of the malleus on the eardrum.  There are multiple different types of prostheses to reconstruct hearing.  This particular type is made from hydroxyapatite, a material very similar to bone. 

4. The eardrum is replaced and allowed to heal once again.

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Dallas Ear Institute
7777 Forest Lane, Suite A-103, Dallas, TX 75230 | Phone: (972) 566-7600 | Fax: (972) 566-6560 | www.dallasear.com