Indications: A. Simple (Cortical) Mastoidectomy: It involves removal of the disease from the mastoid antrum or the air cell system with intact bony external canal wall without disturbing the middle ear contents. Indications: a) Coalescent mastoiditis b) Unresolving Acute otitis media c) As an approach to: ➣ Facial nerve decompression ➣ Endolymphatic sac decompression ➣ Labyrinthectomy B. Radical Mastoidectomy: The mastoid antrum and air cell system, aditus ad antrum, attic and middle ear are converted into a common cavity. The eustachian tube opening is plugged by cartilage .The middle ear remnants of tympanic membrane, malleus and incus are removed, except the stapes foot plate if healthy. Indications:

1. Extensive cholesteatoma with evidence of complications.
2. Recurrent cholesteatoma.
3. Malignancy of mastoid bone or middle ear.
4. Glomus tumours.
5. Tuberculous mastoiditis.

C. Bondy’s Modified Radical Mastoidectomy: This surgery is similar to radial mastoidectomy but the ossicular chain, the mucosa over promontory, if healthy, is kept intact thus preserving as much of the hearing as possible. Indications: Cholesteatoma confined to Attic and Antrum.