浸润性矩阵胆脂瘤

                               
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Edited video showing a combined approach (transcanal + transmastoid) to remove an infiltrative matrix cholesteatoma. These kind of cholesteatoma have an infiltrative characteristics which "sticks" to the bone and must be drilled out. Note the inspection of the retrotympanic area. The philosophy is to clean all we can at the middle ear first, using endoscopes, and then going to the mastoid to perform a cortical mastoidectomy just to reach the antrum and remove the remaining parts of the cholesteatoma. Drilling the mastoid bone is very important in these cases. After, a reconstruction can be performed using cartilage, pericondrium or fascia. It's important to follow these patients to exclude any recurrence and to reconstruct the ossicular chain.