Question
Type of incision as shown in the photograph below is known as ?
A. Transcanal
B. Endomeatal
C. Postaural.
D. Endaural.
Show Answer
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Correct Answer » D Explanation |
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Ans:D. Endaural.
Approaches to Middle ear and Mastoid surgery
Endomeatal (Transcanal or Transmeatal) Approach:
- Rosen incision :A posterior tympanomeatal flap is raised to enter into the middle ear. The flap includes skin over the medial two-thirds of the bony external auditory canal.
Indications:
- Exploratory tympanotomy
- Underlay or Inlay myringoplasty(small posterior perforations and medium-sized perforations )
- Ossiculoplasty (Ossicular reconstruction)
- Stapedotomy and Stapedectomy (Otosclerosis surgeries)
Endaural Approach (Lempert or Heerman incision):
- Incision kept:Lempert -I(Posterior meatal wall in bony-cartilaginous junction),Lempert -II_Curvilinear incision between tragus and helical crus)
- Commonly used in infants and young children
- Accessibility of epitympanum and postero-superior part of mesotympanum
- Temporalis fascia graft or tragal cartilage or perichondrium can be easily obtained
Indications:
- Excision of osteomas and exostoses of ear canal
- Central tympanic membrane perforation
- Atticoantrotomy for Attic cholesteatomas
Postaural Approach
- Wilde’s incision:A postauricular incision is marked 5 mm posterior to the auricular crease in a curvilinear fashion, extending form the mastoid tip to the temporal line.
Indications:
- Cortical mastoidectomy
- Modified radical and radical mastoidectomy
- Tympanoplasty (when perforation extends anterior to handle of malleus)
- Decompression of facial nerve
- Endolymphatic sac surgery
