A 30-year-old woman has a small attic cholesteatoma confined to the epitympanum. Pure tone audiometry shows an air-bone gap of only 10 dB with an intact ossicular chain. Which surgical approach is classically described for this situation?
- A Combined approach tympanoplasty with canal wall up mastoidectomy
- B Bondy's modification of the radical mastoidectomy ✓
- C Radical mastoidectomy with cavity obliteration
- D Atticotomy with removal of the incus and head of malleus
Correct answer: B. Bondy's modification of the radical mastoidectomy
Explanation
Bondy's operation is a modified radical mastoidectomy in which the diseased attic is exteriorised through the posterior meatal wall while the intact ossicular chain and tympanic membrane are left undisturbed, preserving the good hearing. It is indicated for a limited attic cholesteatoma with normal or near-normal hearing. Removing the incus and malleus head would sacrifice hearing unnecessarily, and a combined approach leaves closed spaces requiring second-look surgery in an ear with minimal disease.
Reference: Ballenger's Otorhinolaryngology: Head and Neck Surgery, 18th ed.
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Written and medically reviewed by the StethoPrep medical team.