Hammer and Gouge mastoidectomy

Hammer & Gouge Mastoidectomy

Promoting Education for Developing World ENT

· Hammer & Gouge cortical mastoidectomy for acute mastoiditis

· Hammer & Gouge mastoidectomy for cholesteatoma

These two surgical guides are intended for the many surgeons in the Developing World who do not have access to modern mastoid surgery equipment such functioning mastoid drills, or are regularly faced with power cuts and therefore may be compelled to proceed with a mastoidectomy using a hammer and gouge, and possibly only a headlight and operating loupes.

The text and illustrations are very closely based on the description of mastoid surgery: A Treatise on the Surgical Technique of Otorhinolaryngology (1939) by Georges Portmann. The text has been modified to incorporate modern otological principles.

Mastoid surgery can only be safely performed when the surgeon has an intimate knowledge of temporal bone anatomy. It is imperative that surgeons practice temporal bone dissections as described in this IFOS educational website. Surgeons are also referred to a detailed Temporal bone dissection manual, and an excellent YouTube demonstration of simulated modern mastoid surgery:

We would welcome feedback and advice from surgeons experienced with hammer and gouge mastoid surgery technique, so that this text may be further improved.

Johan Fagan (University of Cape Town, South Africa)

Robert Jackler (Stanford University, USA)

June 2011