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We propose an improved operative technic for the approach to the apex of the petrous portion of the temporal bone by way of the middle fossa. Several operators have approached this region by this route, but in their procedures landmarks and instrumentation have not been stressed so as to clarify and simplify the technic. In most instances the petrous apex was exposed but not entered. When the area of the apex was entered, a hook or a curet was used. The operation which we describe is an attempt to simplify and, if possible, to define the technic so that it will be readily available to the otologic surgeon.
In one of his excellent articles Kopetzky has reviewed the various technics which have been used or advocated and has rendered his critique. Our review of the literature on this subject and our understanding of the pathologic nature of suppuration of the
MYERSON MC, RUBIN HW, GILBERT JG. IMPROVED OPERATIVE TECHNIC FOR SUPPURATION OF THE PETROUS APEX. Arch Otolaryngol. 1934;19(6):699–703. doi:10.1001/archotol.1934.03790060048005
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