title: Modified sleeve tympanotomy approach for removal of congenital cholesteatoma.
abstract: OBJECTIVE
  We present a technique which we have found useful for the management of congenital cholesteatoma extensively involving the middle ear.
  
  
  METHODS
  A five-year-old boy was presented to our department for management of a white mass on the right tympanic membrane. This congenital cholesteatoma extensively occupied the tympanic cavity. It was removed through an extended tympanotomy approach using our modified sleeve technique. The conventional tympanotomy approach was extended by gently separating the tympanic annulus from its sulcus in a circular manner. The firm attachment of the tympanic membrane at the umbo was not severed, in order to avoid lateralisation of the tympanic membrane.
  
  
  CONCLUSIONS
  Although various operative techniques can be used, our modified sleeve tympanotomy approach provides a similarly sufficient and direct visualisation of the entire middle ear, with, theoretically, no possibility of lateralisation of the tympanic membrane and subsequent conductive hearing loss.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University School of Medicine, Seoul, South Korea. hpark@kuh.ac.kr
authors.forename: H J
authors.initials: HJ
authors.lastname: Park
authors.forename: G H
authors.initials: GH
authors.lastname: Park
authors.forename: J E
authors.initials: JE
authors.lastname: Shin
authors.forename: S O
authors.initials: SO
authors.lastname: Chang
mesh_terms: D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000151:congenital / Q000473:pathology / Q000601:surgery*; D004432:Ear, Middle / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006314:Hearing Loss, Conductive / Q000151:congenital / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000473:pathology / Q000601:surgery*