Post-Auricular Approach Video 7.6 mins)
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The Mastoid Periosteum
is Incised

A post auricular incision is used to provide exposure to the ear canal and eardrum for surgical closure of an eardrum perforation.  This approach is especially helpful in anterior perforations, since it gives better surgical visualization of the anterior eardrum.  Temporalis Fascia can also be harvested through this incision. 

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Post-Auricular Approach & Harvesting of Temporalis Fascial Graft

#1:  The ear canal and post-auricular area are injected with 1% Xylocaine with Epinephrine for anesthesia and hemostatsis (to reduce bleeding).
#2:  A post-auricular incision is made, down to mastoid periosteum inferiorly and through the skin superiorly.
#3:  The temporalis muscle and fascia are exposed.
#4:  The mastoid periosteum is incised along the lower border of the temporalis muscle.
#5:  The periosteum over the anterior mastoid tip is elevated
#6:  The temoralis fascial graft is harvested.
#7:  The middle ear is entered.
#8:  After the operation is performed, the external auditory canal is packed with gauze and the post-auricular incision is closed.

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