Stapedectomy and tympanoplasty. III. Mastoidectomy, musculoplasty, and tegmental fascia grafts.

Abstract

The reduction in the size of the mastoidectomy cavity has been a significant contribution in the current renaissance in otological surgery. The cavity may be reduced in size or completely ablated with the temporal fascia graft or flap, the posterior pedicle musculoplasty, the elongated conchal canal flap, the preservation of the bony canal, the use of bone or cartilage chips, and the now classical musculoplasty of Rambo. The classical musculoplasty and ablation of the mastoid cavity is indicated primarily in unilateral ears which require complete radical mastoidectomy. Rather than employ the closed mastoidectomy techniques, I am more frequently inclined to preserve an ear canal and attempt some type of tympanoplastic procedure, either as a primary or as a secondary operation. Fig. 1.—The deep endaural incision is preferred in the small diseased mastoid cavity, for it provides direct access to the antrum, attic, and middle ear, and the healed cavity is