FIELD: otolaryngology.SUBSTANCE: intrameatal incision is made in the
skin of the external
auditory canal along the anterior-inferior-
posterior wall, forming a flap until it rests against the
fibrous ring along its entire length. The
fibrous ring is lifted with a microneedle and the
tympanic cavity is opened along the anterior-inferior-
posterior wall, and the
handle of the malleus is de-epidermized. The individual dimensions of the anterior-superior wall of the bony anulus, the
posterior wall of the external
auditory canal, and the defect of the
eardrum are determined. A disc-shaped structure consisting of two parts connected by a bridge is
cut out from a pre-printed
collagen membrane using a bioprinter. The first part corresponds to the shape of the development of a truncated cone, the second part corresponds to the shape of a disk, the
jumper is made between the disk and the area of the narrow base of the development of the truncated cone. The size of the
jumper corresponds to the possibility of
free movement of the first and second parts relative to each other. The size of the truncated cone scan corresponds to the individual dimensions of the patient. In this case, the area of the wide base of the cone corresponds to the dimensions of the anterior-superior wall of the bony anulus, and the area of the narrow base corresponds to the size of the cross-section of the posterior wall of the external
auditory canal. The
cut structure from the
collagen membrane is placed by putting the first part of the
cut structure in the form of a truncated cone on the
handle of the malleus in the
tympanic cavity. In this case, the placement is carried out in such a way that the wide base of the truncated cone scan covers the anterior-superior wall of the bony anulus, and the narrow base covers the posterior wall of the external auditory canal. The meatotympanic flap is returned to its original position. The second part of the excised
collagen membrane structure, made in the shape of a disk, is brought out through the defect of the
eardrum, above the surface of the defect and laid out on the surface of the remnants of the
eardrum, overlapping them.
Tamponade of the external auditory canal is performed.EFFECT: method allows to increase the effectiveness of tympanoplasty by creating a durable and shock-absorbing adequate structure taking into account the anatomical features of the anterior-superior wall of the bony anulus, the posterior wall of the external auditory canal, and the defect of the eardrum.1 cl, 3 dwg, 1 ex