LESSON 1: Eye, Ear, Nose, and Throat (EENT) Surgery

Section II: EAR SURGERY

1-22

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1-22. INCISIONAL APPROACHES

a. The endaural (vertical) incision frequently is used for temporal operations, except for simple mastoidectomy. The first incision extends from the superior meatus wall, and the second extends directly upward to a point between the meatus and the upper edge of the auricle, where the two incisions join.

b. The high posterior incision may be used in operations on infants or young children. The incision is placed at a higher posterior level than is the endaural incision, thereby avoiding possible damage to the facial nerve.

c. The postaural incision may be used to expose the mastoid process. It follows the curve of the postaural fold, beginning at the upper attachment of the auricle and continuing behind the postaural fold downward to the tip of the mastoid process.

d. For stapes surgery, a circumferential incision is made in the posterior half of the canal, starting at the inferior aspect of the annulus and ending posterior to the short process of the malleus.

e. For myringotomy, a circumferential (posteroinferior) incision is made. It provides for wide drainage and removal of pus or fluid under pressure from the middle ear.

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