Optional Mastoidotomy

In most of these patients, intractable cholesteatoma or granulation tissue in a sclerotic mastoid indicates that the surgeon should proceed directly to mastoi-dectomy, but in a few patients the status of the mastoid is unclear. For these patients, mastoidotomy,

to prulccl flap

either through the posterior wall of the ear canal through a small opening or under Macewen's triangle if preoperative radiographs show adequate pneumatization, can help safely identify the extent of the pathologic tissue. In extremely sclerotic mastoids, mastoidotomy is not indicated.

Anlcrior can ai

Anlcrior can ai

FIGURE IO-4 Posterior canaloplasty.

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