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Here a new fresh wet Graft is added to restore the perforated tympanic membrane. The reinforcement is done by placing graft in between remnant tympanic membrane on the top and the mucosa at the bottom. This sandwich method of the surgery has the greatest advantage of graft stability during healing giving better blood supply to the graft and giving a 100 percent success rate.
This can be used in cases of small perforations, accessible canals with no frequent infections. This is an internal approach with no external incision. It gives a better surgical view and reduces the surgical duration.
Combined Approach Tympanoplasty, Canalplasty, Mastoidectomy Atticotomy and ossiculoplasty and Canal Reconstruction.
In this surgery we take out the disease- Cholesteatoma into toto without disturbing the normal shape and size of the ear. We also restore the hearing at the same time .
With this improvised technique we can avoid doing a Modified Radical Mastoidectomy which has the disadvantages of decreased hearing, forming a big cavity which requires a lot of ear cleaning periodically.
This procedure is used in cases of extensive Cholesteatoma which has eroded all the neighbouring structures andv ossicles.
Here after the removal of the entire disease we go and make the ear look normal like before and get back the hearing and negate the sidefeffcts of the MRM.
Stapes is the smallest bone in the body with a dimension of the footplate being 3mm in length to 1.5 mm in width and a mean thickness of 0.2mm.
The aim of the surgery is to make a fenestration that is a hole in the footplate with a diameter 0.6mm and to insert a piston with a diameter of 0.5mm.
The skeeter does the fenestration (hole) in very precise manner with out disturbing the underneath of the stapes footplate .
The traditional method of doing this fenestration with perforaters has a lot of disadvantages of breaking the foot plate
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