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At the Middle Section meeting of the Triologic Society, Ann Arbor, Mich, Jan 23, 1988, Michael Morris, MD, Michael Paparella, MD, and Sady S. DaCosta, MD, Minneapolis, reported their experience that has evolved over many years in establishing a flexible surgical approach to otologic disease. The authors observed that pathologic findings noted at the time of surgery frequently will be significantly different from the preoperative diagnosis. To obviate the possibility of ignoring or missing substantial disease, the authors propose an intraoperative diagnostic approach to the extirpation of disease. The technique employed begins all cases with a Lempert endaural incision and progresses to include, as necessary, canalplasty, exploratory tympanotomy, ossiculoplasty, atticotomy, mastoidotomy, and mastoidectomy, resulting in a progressively enlarged surgical field.
By means of surgical case reports and details of the operative techniques, the authors correlated their observations with well-documented mechanisms of pathobiologic processes associated with diseases of the ear.
PENSAK ML. Flexible Methodology in the Surgical Approach to Otologic Disease. Arch Otolaryngol Head Neck Surg. 1988;114(10):1084. doi:10.1001/archotol.1988.01860220018005
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