31Medical Treatment Topical ear drops + frequent suction clearance Indications:Early disease with shallow retraction pocketOnly hearing ear with cholesteatomaElderly patientsPts who are not fit for surgery under G.A.Pts who can regularly come for follow up
93Perform cortical mastoidectomy Perform cortical mastoidectomy. Lower facial ridge & break facial bridge. Remove cholesteatoma & granulations from mastoid air cells & middle ear.Remove normal middle ear mucosa, T.M. remnant & ossicles (except stapes footplate).Close Eustachian tube opening. No tympanoplasty done. Concho-meatoplasty performed.Mastoid, E.A.C. & middle ear become single cavity.
94Indications 1. CSOM attico-antral disease with Intra-cranial complication Recurrence after modified radical mastoidectomy Profound sensori-neural hearing loss (?)2. Limited malignancy of middle ear3. Glomus jugulare4. Osteomyelitis of temporal bone