Tympanomastoidectomy
Objective
In cases of loss of hearing due to chronic suppurative ottitis
media with unsafe atticoantral type disease.
Position
Supine with head turned diseased side up.
Anesthesia
Local.
Procedure
1. Post aural/and aural incision.
2. Harvesting the temporalis fascia graft.
3. Elevation of posterior meatal wall skin flap.
4. “Outside in”/or “Inside out” approach to be
used for bone work.
5. Exploration of mastoid antrum.
6. Exposure of tegmen tympani, sinus plate, tip
cells and lateral semicircular canal.
7. Removing the posterior meatal wall and
defining the fascial ridge.
8. Clearance of disease from peripheral
labyrinthine cells and removal of outer attic and wall bridge.
9. Clearance of disease from middle ear.
10. Wide meatoplasty.
11. Reconstruction of ossicular chain, and
placement of graft.
12. Gelfoam/ear packing.
13. Closure of skin wound.
Instruments
• Stapes set 1
• Skin
knife
• Iris
scissors
• Fine
forceps
• Cautery
mastoid drill
• Mastoid
retractor
• Gauges
• Chisel
• Bone
curettes
• Suction.
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