TYPE OF SURGERY: Canal wall up with bony obliteration for CSOM with history of cholesteatoma SURGICAL TECHNIQUE: 1) Retro-auricular approach 2) Attico-antro-mastoidectomy.

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TYPE OF SURGERY: Canal wall up with bony obliteration for CSOM with history of cholesteatoma SURGICAL TECHNIQUE: 1) Retro-auricular approach 2) Attico-antro-mastoidectomy CWU+ harvesting of bone powder 3) Removal of cholesteatoma 4) Attic, Posterior tympanotomy closure with bone chips 5) Bony obliteration of attic, antrum and mastoid 6) Cartilage tympanoplasty and ev. ossiculoplasty 7) Closure LION TV CHANNEL 1 CASE 1/2 (10h 00 – 11h 45) SURGEON: Thomas Somers European Institute for ORL St Augustinus Hospital Antwerp (Belgium) St Augustinus Hospital, Antwerp The 8 th LION Global Broadcast May 16 th, 2013

LION TV CHANNEL 1 Thomas Somers. Cholesteatoma. Left Ear CLINICAL History: Male 34 y Longstanding bilateral otorrhea and hearing loss, No vertigo, no tinnitus, good general condition Otoscopy: L Attic retraction, epithelial debris, pus R Attic retraction (also to be operated in the future) St Augustinus Hospital, Antwerp The 8 th LION Global Broadcast May 16 th, 2013

LION TV CHANNEL 1 Thomas Somers. Cholesteatoma. Left Ear St Augustinus Hospital, Antwerp The 8 th LION Global Broadcast May 16 th, 2013 (Please audio here)

LION TV CHANNEL 1 HR-CT-Scan: Sclerotic mastoid, Opacified ME,Attic, Antrum. Scutum defect, thin attic bony plate, no fistula, eroded ossicles, covered bony facial canal MRI: Large cholesteatoma in the attic, antrum, mastoid LION TV1 - 15/59 Thomas Somers. Cholesteatoma. Left Ear St Augustinus Hospital, Antwerp The 8 th LION Global Broadcast May 16 th, 2013

LION TV CHANNEL 1 CASE 2/2 (14h 00 – 15h 30) SURGEON: Thomas Somers European Institute for ORL St Augustinus Hospital Antwerp (Belgium) St Augustinus Hospital, Antwerp The 8 th LION Global Broadcast May 16 th, 2013 TYPE OF SURGERY: Surgery for CSOM with history of cholesteatoma PLANNED SURGERY: Subtotal petresectomy SURGICAL TECHNIQUE: Blind sac closure, radical mastoidectomy and removal of cholesteatoma, filling of the cavity with abdominal fat, closure (BAHA or Bone bridge in second stage if hearing preserved and after MRI control)

LION TV CHANNEL 1 Thomas Somers. Cholesteatoma revision. Left Ear St Augustinus Hospital, Antwerp The 8 th LION Global Broadcast May 16 th, 2013 CLINICAL History: Cholesteatoma surgery elsewhere: 1983,1985,1989 Otoscopy: R side: massive polyp, no eardrum seen L side: dry attic retraction

LION TV CHANNEL 1 LION TV1 - 14/59 Thomas Somers. Cholesteatoma revision. Left ear St Augustinus Hospital, Antwerp The 8 th LION Global Broadcast May 16 th, 2013 (Please audio here)

LION TV CHANNEL 1 St Augustinus Hospital, Antwerp The 8 th LION Global Broadcast May 16 th, 2013 CB-CT-Scan