A number of otologists have adopted the endaural method of approach to the mastoid described by Dr. Julius Lempert, of New York. A number of them employ this method of approach occasionally. Some of them are doing fistulization for deafness as described by Dr. Lempert, in which case the endaural approach is practically indispensable.
One of the inconveniences of this method is the lack of a self-retaining retractor on the market which would serve satisfactorily. An assistant, therefore, is employed solely for the purpose of holding hand retractors throughout the operation.
The operation for deafness requires many hours, and it is an ordeal for an assistant to sit through it holding the retractors. In this approach it is necessary to shift retractors from one point to another. Therefore, none of the retractors on the market which are fixed at one point serve the purpose. These retractors also fail to spread