Mrmc Neo Surgical Ventilating Port and Neo Attic Malleo-Incudal Complex in Endoscopic Management of Limited Attico-Antral Cholesteatoma

  • C. B. Nandyal
  • Mithun Sutrave
  • Vinayak Kurle
  • Pallavi A. Harsoor
Original Article


To study functional outcome of the endoscopic management of limited attico-antral cholesteatoma in terms of visualization of sac, cholesteatoma disease clearance, ABG closure improvement, preservation of residual anatomy and recurrence of disease. It is a prospective study done during Feb 2016 to March 2017 done on 20 pts with limited attico-antral cholesteatoma with CT confirmation. Endoscopic management of limited attico-antral cholesteatoma with complete removal of sac, infected discharge and granulations along with creation of MRMC Neo surgical ventilating port (joining Anterior & posterior isthmuses) done in cases where residual attic anatomy was present to establish physiological attic ventilation and drainage. Whereas in cases of attic and ossicular erosion, ossiculoplasty along with neo attic malleo-incudal complex (with composite tragal cartilage with perichondrium graft) for lateral attic wall reconstruction was done to prevent attic retraction. Patients had mean pre op ABG of 36.29 ± 6.29 and mean post op ABG closure of 16.33 ± 6.50 with no recurrence of cholesteatoma at 6 months of follow up. Patient showed significant (55%) improvement in hearing with all having graft uptake in which four cases having mild pars tensa retraction which recovered later without any intervention. Thus creation of new MRMC Neo surgical ventilating port or neo attic malleo-incudal complex with endoscopic approach allows better visual access to clear the limited attico-antral disease with sparing of normal residual attic anatomy along with physiological ventilation and drainage having better hearing results and outcome.


Attico-antral cholesteatoma Endoscopic ear surgery Middle ear mucosal folds Spaces Ventilation 


Complaince with Ethical Standards

Conflict of interest

There was no conflict of interest and no funding was received for the research.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Prior approval from ethical committee of the institute was taken.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Association of Otolaryngologists of India 2017

Authors and Affiliations

  1. 1.Department of ENTMRMCGulbargaIndia

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