Ventilation of the middle ear cavity

Abstract

Pneumatization of the middle ear cavity is important for managing the cholesteatoma and adhesive otitis media. Severely diseased ears have little pneumatization and consequently the dysfunction of the sound conduction system. The ventilation through the Eustachian tube and the gas exchange through the middle ear mucous membrane control the pneumatization of the middle ear cavity. The Eustachian tube mainly works for ventilating the middle ear cavity. To achieve the inflammation free middle ear and good sound conducting condition, we need the pneumatization minimally in the mesotympanum. From our thought, it is difficult to make a big pneumatized cavity by operation in these severely diseased cases. We introduce our operative method for making the minimum pneumatized cavity in the mesotympanum. Our operative method is the canal wall down but closed method tympanoplasty with intact canal skin method and with the canal reconstruction by attic, antrum and mastoid obliteration using bone pate. Using silicone plate, the mucous membrane in the Eustachian tube has been induced to the mesotympanum. We think that the success of tympanoplasty for adhesive otitis media is to succeed to reconstruct the pneumatization in the mesotympanum. We show our results of operation and discuss about our operative methods.