Curvi-linear scar over the incisura area.
Fine healed post-auricular curvilinear surgical scar.
Intact right malleolar-incudal complex in the epitympanum after
healed cholesteatoma surgery. Posteriorly leads to aditus ad-antrum.
View of epithelialized postero-superior cholesteotoma after ear toilet performed.
Healed atticotomy cavity and cholesteatoma-free.
Figure shows epitheliazed post-atticotomy cavity
with some earwax cumulation superiorly.
The epitympanum view after ear toilet showing missing
head of malleus with its adjoining body of incus.
Figure shows the facial nerve (arrow) course in the middle
(horizontal segment) before it turns inferiorly as the
vertical segment a patient who had surgery perfomed for atticoantral disease.
Horizontal segment of facial nerve (arrow)
A clean mastoid cavity.
The high-definition image of the same patient's mastoid cavity above.
Figure shows a well-epithealized mastoid cavity after a canal wall down surgery.
Mastoid cavity with epithelial crusts and some earwax.
Figure shows a localized entrapped keratin (arrow)
in a patient who had canal wall down surgery for cholesteatoma.
Early recurrence of cholesteatoma in a mastoid cavity manifested as epithelial pearls (arrows). (TM - tympanic membrane, A - anterior, P -posterior)
Follow-up assessment and inspection serve several objectives:
i. To monitor healing and recovery.
ii.To clean the cavity from epithelial debris or earwax cumulation.
iii.To detect and treat concurrent infection e.g. otomycosis.
iv.To diagnose residual or recurrence disease and plan for further therapeutic intervention.
Another example showing crusts (arrow) in a well-epitheliazed cavity.
Otomycosis occuring after cholesteatoma surgery.
Sequential endoscopic images of right auditory meatus showing post-surgery changes in a 4 year old child who had cholesteatoma operation 2 years earlier. Except for the hearing loss, she is otherwise asymptomatic.
(Epithelial migration figures are courtesy of Dr G Revadi)