Intact-bridge mastoidectomy

Open cavity and closed cavity tympanomastoidectomies both have specific advantages and disadvantages. In 1983, Paparella and Jung developed the "intact bridge mastoidectomy" (IBM) technique, which has provided excellent results through the past four decades (Paparella and Jung, J Laryngol Otol 97:579-585, 1983). The most critical advantages of the IBM technique are that it combines the most important features of both open-cavity (intact canal wall) and closed-cavity (canal wall down) techniques, allowing eradication of disease and reconstruction of hearing mechanisms in a single-stage procedure; allows better reconstruction of the middle ear and ossicles and enhances tympanoplastic methods; and enhances obliteration of the mastoid, when that is indicated. The IBM procedure is a safe procedure that combines the most prominent advantages of the open-and closed-cavity mastoidectomies, being one among the procedures used to treat chronic otitis media. The IBM, when executed with sufficient expertise, provides a clean and dry middle ear and mastoid while also preserving and enhancing hearing.