The pedicle graft in tympanomastoid surgery.

Indications for Obliteration and Closed Mastoid Operations

“…The complete absence of signs and symptoms of intracranial or labyrinthine complications. 5. Chronic suppuration of the mastoid without evidence of cholesteatoma in the various cell extensions of the epitympanum or antrum.…”

“…complications including labyrinthine fistula, intracranial lesions, and lateral sinus throm¬ bosis secondary to a pathological process in the mastoid; (3) when widespread choles¬ teatoma makes doubtful the total removal of all squamous epithelium; (4) when removal of infected or possibly infected mastoid cells may have been incomplete; (5) when the patient has uncontrolled diabetes or is known to have poor tissue resistance to infection; and (6) when a specific drug is not available as demonstrated by sensitivity tests in the presence of gram negative organ¬ isms, especially pseudomonas or proteus. A thorough discussion of the subject requires division of the material into obliteration and closed cavity (the maintenance of a poste¬ rior bony canal wall with posterior tympanot¬ omy) since the indications for the applica¬ tions for each method differs depending on the disease process and the philosophy and experience of the surgeon.…”