Cortical Mastoidectomy and Cortical Mastoidectomy and Combined Approach Tympanoplasty Combined Approach Tympanoplasty

(CAT)(CAT)

Relevant AnatomyRelevant Anatomy

Cortical MastoidectomyCortical Mastoidectomy

Combined Approach TympanoplastyCombined Approach Tympanoplasty( ie “canal wall up”, “intact canal wall”, “closed-cavity ( ie “canal wall up”, “intact canal wall”, “closed-cavity tympanomastoidectomy”)tympanomastoidectomy”)

Reported AdvantagesReported Advantages

• Avoids open mastoidectomy cavity and its problemsAvoids open mastoidectomy cavity and its problems

• More physiologic and better for reconstruction of ossicular More physiologic and better for reconstruction of ossicular chainchain

• Allows an individual to go swimmingAllows an individual to go swimming

Disadvantages of CAT SurgeryDisadvantages of CAT Surgery

1. Higher incidence of failure in literature.1. Higher incidence of failure in literature.

2. Potentially dangerous in sclerotic mastoids.2. Potentially dangerous in sclerotic mastoids.

3. Need for second look procedure (?)3. Need for second look procedure (?)

4. Greater degree of surgical skill required.4. Greater degree of surgical skill required.

Facial Recess Approach #1Facial Recess Approach #1

Facial Recess Approach #2Facial Recess Approach #2

Facial Recess Approach #3Facial Recess Approach #3