Any operation should follow the route affording the best view of the surgical field, and that route should be as short as is compatible with due consideration for healthy tissue. The postaural incision is the direct approach to the mastoid process, but it gives a limited view of the middle ear. The approach through the external auditory canal leads directly to the tympanic cavity, but with the previously available methods it is practicable by this route to resect the cell system of the mastoid process only to a limited extent; besides, the field of vision is small, and the room for operative maneuvers limited.
The Lempert endaural approach to the temporal bone offers the great advantage that the surgeon is enabled at once to resect any cell system, regardless of its extent, just as through the postaural incision, and at the same time to have a direct view of and
KETTEL K. THE LEMPERT ENDAURAL, ANTAURICULAR SURGICAL APPROACH TO THE TEMPORAL BONE: SUGGESTED MODIFICATION OF THE TECHNIC IN TYMPANOMASTOIDECTOMY; REPORT OF FIFTY-FIVE CASES. Arch Otolaryngol. 1941;34(3):461–472. doi:10.1001/archotol.1941.00660040501003
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