Figure 1. Diagram of open mastoidectomy (CWU) with reconstruction of the posterosuperior wall and middle ear in one surgery. A. One retro-auricular incision is made. B. Mastoid approach with traditional milling. The posterior wall of the EAC was milled to completely expose the facial recess, tympanic sinus, and hypotympanum. C. Milling of the COG (epitympanic ridge dividing the anterior tympanum from the posterior) in the epitympanum until completely exposed (exposure of the anterior and posterior epitympanum). Cholesteatoma was resected, and all spaces were cleaned. D. Mastoid occlusion was performed with powdered bone, cartilage, muscle, and/or temporal fascia. For reconstruction of the ossicular chain, autologous material or titanium prosthesis was used (PORP or TORP).