Which of the following is not included in the radical mastoidectomy?
A. Closure of the auditory tubeB. Ossicles removed
C. Cochlea removed
D. Exteriorization of mastoid
Answer. B. Ossicles
removed.
A
simple mastoidectomy
consists of opening the mastoid cortex and identifying the aditus and antrum.
A
complete or canal wall up mastoidectomy necessitates removal of all of the mastoid air cells along the
tegmen, sigmoid sinus, presigmoid dural plate, and posterior wall of the
external auditory canal. The posterior wall of the external auditory canal is
preserved.
A
canal wall down mastoidectomy includes a complete mastoidectomy in addition to removal of the
posterior and superior osseous external auditory canal. The tympanic membrane
is reconstructed to separate the mucosal lined middle ear space from the
mastoid cavity and ear canal.
A
modified radical mastoidectomy is identical to a canal wall down mastoidectomy except the middle
ear space and native tympanic membrane are not manipulated. This procedure is
useful when there is no extension of
cholesteatoma in
the middle ear space or medial to the malleus head or incus body. This
procedure is often indicated in patients with a
cholesteatoma in their only or better hearing ear.
A
radical mastoidectomy
is a complete mastoidectomy in which the tympanic membrane and ossicles are not
reconstructed, thus exteriorizing the middle ear and the mastoid. The
eustachian tube is often obliterated with soft tissue to reduce the risk of a
chronic otorrhea. A skin graft can be placed in the middle ear to reduce the
risk of mucosalization and otorrhea.
