CPT® Code 69604

The procedure described by CPT® Code 69604 refers to a revision mastoidectomy that results in tympanoplasty. This surgical intervention is performed to address complications or failures from previous mastoid surgeries, particularly when there is a need to repair the tympanic membrane (eardrum) and manage chronic ear infections or other related conditions. During the procedure, an incision is made behind the ear to access the mastoid bone, which is the bony structure located behind the outer ear. The surgeon inspects the mastoid air cells, which are small air-filled spaces within the mastoid bone, to assess the extent of any infection or damage. The revision process involves the complete removal of the mastoid air cell system, along with any purulent matter, debris, and infected tissue that may be present. In some cases, the procedure may require the removal of the posterior and superior walls of the external auditory canal to enhance visibility and access to the mastoid and attic of the middle ear. If the condition necessitates a more extensive approach, a radical mastoidectomy may be performed, which involves the removal of critical structures within the epitympanum, including the head of the malleus and the body of the incus, and potentially the stapes, although efforts are made to preserve it when possible. This extensive removal allows for the exteriorization of the mastoid cavity and middle ear, facilitating better drainage and healing. Following the mastoidectomy, the tympanic membrane is repaired, which may involve rimming the edges of the perforation to promote healing or using a graft for larger holes. The procedure concludes with the placement of absorbable materials to support the graft and packing the ear with gauze to ensure stability during the recovery process.