FIGURE LEGENDS
Figure 1 . Preoperative findings. (A) The damage of attic was observed by otoscope. There is a deep pocket in the right ear slack (arrow). White cholesteatoma in the left ear in front of the malleus (arrow). (B) In the coronal HRCT temporal bone scan (arrow), the Prussian space has lobulated soft tissue, and the middle small bone is displaced, which erodes the attic of scutum (*) (arrow). (C)Pure tone audiogram. 90% of patients with cholesteatoma have symptoms of conductive hearing loss caused by erosion of auditory bone.
Figure 2. A patient with intermittent otorrhea and earache was treated by microsurgery. (A) attic damage occurs when the left tympanic membrane is examined before operation. (B) The tympanic membrane became clear in the attic area after postoperative examination. (C) cholesteatoma matrix (f, facial nerve; P, Cape; In the 1980 s, stapes were completely removed. (d) Implant cartilage (arrow) when rebuilding attic area.
Figure 3. One patient experienced hearing loss and intermittent otorrhea. Endoscope was used to treat attic cholesteatoma. (A) The attic was found damaged during the preoperative examination. (B) The attic was found to be clean after the operation. (C) After gastrectomy, white cholesteatoma was found by endoscope (arrow). (D) Reconstruction of attic with cartilage after removal of cholesteatoma (arrow).
Figure 4. The visibility index of middle ear structure (MESVI) after endoscopic and microscopic gastric wall incision
Figure 5. Postoperative manifestations-after endoscopic and microscopic pubic symptomy.
Figure 6. Long-term results of 1-year postoperative follow-up
Supplement figure 1. Middle ear structure visibility index (MESVI). (A) Observation results of middle ear structure under 0 endoscope. (B)With some important anatomical signs (public relations: Cape, Jacobson nerve, hy: hypotympanum, fi: finiculus, SST: SUPTYMPANICSE: styloid process bulge, pe: pyramidal bulge, saint: stapes tendon, isj: incudostapedial joint, fn: face) Sp: short process, nurse: malleus neck, ttm: tensor timulus muscle, ttf: tensor timulus fold, ica: internal carotid artery, cp: cochleariform process, lsc: lateral semicircular canal, safety factor: stapes foot) was used as the MESVI 10-point scoring system.