Cortical mastoidectomy is indicated in –
**Core Concept**
Cortical mastoidectomy is a surgical procedure aimed at removing diseased mastoid air cells while preserving the cortical layer of the mastoid bone. This procedure is typically performed to treat complications of acute otitis media, such as mastoiditis, or to access the middle ear for repair of a perforated eardrum.
**Why the Correct Answer is Right**
The correct indication for cortical mastoidectomy is mastoiditis, an inflammatory condition of the mastoid bone caused by the spread of infection from the middle ear. The procedure helps to relieve pressure and drain the infected mastoid air cells, thereby reducing the risk of serious complications, such as intracranial abscess or facial nerve paralysis. Cortical mastoidectomy is a conservative approach compared to a more extensive procedure called radical mastoidectomy.
**Why Each Wrong Option is Incorrect**
* **Option A:** Cholesteatoma is a type of skin cyst in the middle ear, and while it may require surgical intervention, cortical mastoidectomy is not the preferred treatment. The standard approach for cholesteatoma involves a more extensive procedure called canal wall-up or canal wall-down mastoidectomy.
* **Option B:** Ossicular discontinuity, a condition where the bones of the middle ear are damaged, may require surgical repair. However, cortical mastoidectomy is not the primary procedure for addressing ossicular discontinuity.
* **Option D:** Cochlear implantation is a procedure to restore hearing in individuals with severe to profound sensorineural hearing loss. Cortical mastoidectomy is not indicated in this context.
**Clinical Pearl / High-Yield Fact**
When considering surgical intervention for middle ear or mastoid disease, it's essential to distinguish between acute and chronic conditions, as well as the extent of disease involvement. Cortical mastoidectomy is a conservative approach for treating mastoiditis, but more extensive procedures may be necessary for other conditions.
**Correct Answer:** C.