Canal Wall Down (Radical Cavity)

  • Christoph Arnoldner
  • Vincent Y. W. Lin
  • Joseph M. Chen


The posterior canal wall is taken down mainly in cholesteatoma cases when a wide overview of the middle ear structures is necessary. Initially the canal wall is usually preserved to have a landmark for the mastoidectomy. When the canal wall is then taken down, drilling is performed parallel to the facial nerve. Once you are medial to the tympanic annulus, it is important to take down the bone overlying the facial nerve (“facial ridge”) as much as possible to allow cleaning and inspection of the middle ear space (Video 5). This is known as lowering the facial ridge and an important step to reduce the incidence of leaving cholesteatoma matrix behind. In this context, also the importance of a wide meatoplasty should be highlighted (Video 6). Once the canal wall is removed, the entrance into the eustachian tube and the canal of the tensor tympani can be seen. The carotid artery lies medial to the eustachian tube (Fig. 8.1).


Carotid Artery Facial Nerve Neck Surgery Semicircular Canal Eustachian Tube 
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Supplementary material

Video 5

(WMV 55960 kb)

Video 6

(WMV 80851 kb)

Copyright information

© Springer-Verlag Wien 2015

Authors and Affiliations

  • Christoph Arnoldner
    • 1
  • Vincent Y. W. Lin
    • 2
  • Joseph M. Chen
    • 2
  1. 1.Department of OtorhinolaryngologyMedical University of ViennaViennaAustria
  2. 2.Department of Otolaryngology Head & Neck SurgerySunnybrook Health Sciences CenterTorontoCanada

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