Abstract
Tympanomastoidectomy is the workhouse of the otology-neurootology surgeon. It involves various techniques depending on the surgical goals, extent of pathology, and patient factors. Indications include chronic otitis media, cochlear implantation, facial nerve surgery, and various lateral skull base approaches. Techniques range from simple mastoidectomy, canal wall down/up variant to subtotal petrosectomy, and labyrinthectomy, each tailored to specific indications. For all these approaches, a good anatomical knowledge of anatomical structures such as facial nerve, sigmoid sinus, dura, semicircular canals is crucial to avoid complications. Mastery of tympanomastoidectomy is essential for optimal patient outcomes in a variety of pathologies and surgical needs.