[The innovative surgical technologies for the treatment of chronic suppurative otitis media]

Chronic suppurative otitis media (CSOM) is a most common pathology among all other ENT diseases that accounts for approximately 48% of the total number of their cases. Modern surgery witnesses the advent of new methods for the management of these conditions in parallel with the modification of the known techniques intended to improve the post-operative outcomes of the treatment and rehabilitation of the patients. The objective of the present study was to enhance the effectiveness of the surgical treatment of the patients presenting with chronic suppurative otitis media by making use of the relevant navigation systems. A total of 29 patients presenting with CSOM underwent the surgical intervention on 31 ears. The open variant of sanation surgery on the middle ear was chosen including the hearing-improving component or without it depending on the extension of the pathological process under control of the Navigation Panel Unit ('Karl Storz', Germany) and KICK ('BrainLab', Gerfmany) navigation systems. Special emphasis is placed on the selected peculiar features of their application. It was shown that the use of the aforementioned navigation systems considerably improved the field of vision and the orientation in all compartments of the middle ear which made it possible to prevent the potential intra-operative (in all 31 cases) and post-operative complications. None of the patients suffered complications within 2 months after the onset of the treatment. The microotoscopice examination revealed the signs of the inflammatory process in three patients 6 months after surgery. Only one patient was suspected to have a recurrent cholesteatoma 12 months after the surgical intervention. The second operation included the removal of the cholesteatoma pearl, revision of the post-operative cavity, and re-tympanoplasty. The most important positive effects expected from the application of the navigation systems include the improved orientation in three dimensions that gives assurance to the surgeon thereby making his actions more accurate and precise and the reduction of the duration of the surgical intervention.