The whole procedure of open surgery for cholesteatoma-type otitis media, exemplified by microscopic mastoid pathway tympanoplasty, is as follows:
1. general anesthesia is intubated through the mouth.
2. Positioning: the patient is lying on his back, with his head tilted to the healthy side and the operated ear facing outward and upward.
3. Sterilization: Periauricular, both sides of the auricle and external auditory canal are routinely sterilized with iodine. A sterile perforated towel should be laid.
4. Posterior auricular sulcus incision, up to the level of the auricle, down to the tip of the mastoid, curved, about 4 cm long, incise the skin and subcutaneous tissues layer by layer, electrocautery hemostasis, separation of the mastoid periosteum, exposure of the mastoid osseous cortex, up to the temporal line, down to the tip of the mastoid, and posteriorly to the ethmoidal sinus incision, through the sieve area access, contouring of the mastoid.
5. Resect the lateral bony wall of the tympanic chamber and the posterior bony wall of the external auditory canal to fully expose the middle and upper tympanic chambers.
6. Thoroughly remove the granulation of the tympanic chamber and sinus or cholesteatoma and other diseased tissues, and examine and treat the necrotic auditory ossicles.
7. Through the postauricular incision, perform ossicular turbinoplasty and ossiculoplasty to enlarge the opening of the external auditory canal.
8. Take the temporal muscle fascia and perform tympanic membrane repair with built-in method to reconstruct the auditory ossicles. The tympanic membrane is fixed with absorbable gelatin sponge on the inner and outer sides, and the mastoid cavity is filled with iodoform gauze.
9. Intermittent suture closure of the postauricular incision, pressure bandage in the operation area.
10. After the patient wakes up satisfactorily, return to the ward.