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Glomus Tympanicum
Revision surgery. Subtotal petrosectomy
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| 1. Planning the incision. Retraction of the retroauricular skin due to former mastoidectomy. | 2. Incision. Periosteal flap. The cavity of the former mastoidectomy is seen. |
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| 3. Refinement of the mastoidectomy. Epitympanotomy.. | 4. Completion of the epitympanotomy. The body of the incus is seen. |
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| 5. Skeletonization of the sigmoid sinus. New bone formation is seen on the sinus. | 6. Searching for the digastric ridge. |
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| 7. The region of origin of the digastric muscle is seen. | 8. Trying to locate the jugular bulb. |
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| 9. The blue color of the jugular bulb begins to appear. | 10. Drilling Bill’s island. |
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| 11. The operation continuous through the meatus. The tympanic bone is removed. | 12. View of the tumor in the hypotympanum. |
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| 13. Continuing the removal of the tympanic bone. | 14. Gradual detachment of the tumor from the hypotympanum. |
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| 15. Continuing the detachment of the tumor and the mucosa. | 16. While the tumor is being dissected, a small remnant is left behind, anteriorly and inferiorly. |
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| 17. The remnant is almost completely separated from the bulk of the tumor. | 18. Drilling towards the jugular bulb. In front of the suction tip appears the figure of the internal carotid. |
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| 19. Mobilization of the tumor and removal with the suction. | 20. Removal of the tumor remnant. |
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| 21. The continuation of the drilling reveals another remnant which is also removed. | 22. The removal of bone from the hypotympanum leads to the disclosure of the dura of the posterior cranial fossa. |
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| 23. Elevation of the tympanic membrane. Due to adhesions, the mucosa of the promontory is also detached revealing cochlea. | 24. Separation of the incudostapedial joint to explore the oval window. |
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| 25. Removal of the adhesive mucosa. | 26. Receiving temporal fascia and muscle graft. |
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| 27. Covering the hypotympanic cavity with the compound graft. | 28. Packing with absorbable pledgets. |
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| 29. Suturing the periostium. |
