Surgical technique for open mastoid procedures.

In mastoid surgery for chronic ear disease (with or without cholesteatoma), the removal of the posterior canal wall does not necessarily insure a "safe" ear. Open procedures are subject to many of the same complications that are associated with the more controversial closed technique. In addition, if the canal wall down procedure is not performed with great care and under strict guidelines, the postoperative ear can be a continual nuisance to the patient. The author has reached these conclusions based upon 20 years' experience in dealing with "problem cavities" created by himself and others. The purpose of this paper is to define the "problem cavity" and how to prevent it.