Radical mastoidectomy cavity with debris and exposed middle ear mucosa.

The otoscopic view is that of a left ear that has had a radical mastoidectomy. Infected epithelial debris covers the mastoid cavity and middle ear mucosa. At the bottom of the photograph is a skin-covered mound, which is at a remanent of the posterior external auditory canal bone. To the left is the mastoid cavity, which is lined with dead, greenish, infected skin. In the center of the photograph is the exposed epitympanic mucosa. To the right is the exposed mucous membrane of the tympanum and tubotympanum. The bacteria that usually produce otorrhea are Staphylococcus aureus, Pseudomonas and Proteus. Treatment to eliminate the superficial infection is frequent profuse irrigation with body-temperature vinegar. Revision tympanoplasty, mastoidectomy, and mastoid obliteration, usually with bone paste, can provide definitive relief.

From the Pulec Ear Clinic, Los Angeles (Dr. Pulec), and Gap, France (Dr. Deguine).