THE FACTORS contributing to a successful hearing result in tympanoplasty are frequently at diametric odds with those required for surgical irradication of pathologic tissue in chronic otitis media with mastoiditis. Cholesteatoma has a predilection for surrounding the malleus head and extending anteriorly into the attic. Granulations can nearly always be found in the posterior tympanic recess and retrofacial cells. Clearing the attic by removing the incus and the head of the malleus is the only certain way to provide adequate visualization for complete removal of all cholesteatoma in this area. Complete cleaning of the posterior tympanic recess and retrofacial cells requires removal of the posterior tympanic sulcus and lowering the facial ridge to the level of the fallopian canal, leaving a medially displaced tympanic membrane and a shallow posterior middle ear cleft. In each instance, in order to obtain direct surgical access to the pathology present, one of the lateral
Turner JL. Hearing Results in Malleostapediopexy. Arch Otolaryngol. 1969;89(3):499–503. doi:10.1001/archotol.1969.00770020501011
Monkeypox Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.