Insights in the Physiology of the Human Mastoid: Message to the Surgeon

To reach the temporal bone, surgeons often consider making access through the mastoid. It is, however, imperative that the surgeon is aware of the mastoid’s morphology, physiology, its functional parameters and the implications of damaging or altering this structure. We review established findings on the developmental and functional morphology, and the delicate pressure balance variations in the middle ear cleft. Then, an overview is given of the possible surgical access methods for the temporal bone through the mastoid. We look for implications of each procedure, which can only be understood through the knowledge of the preceding outline, so that surgeons can justify a certain surgical approach.