CPT® Code 69605

Deleted

The procedure described by CPT® Code 69605 is known as a revision mastoidectomy with apicectomy. This surgical intervention is primarily indicated for patients experiencing recurrent infections of the mastoid air cells, particularly when these infections have extended to the petrous apex, which is a part of the temporal bone located at the base of the skull. The procedure begins with an incision made behind the ear, allowing the surgeon to access and expose the mastoid bone. During the operation, the surgeon inspects the remaining mastoid air cells to assess the extent of the infection and determine the necessary revisions. The surgical approach involves the complete removal of the air cell system, along with any purulent matter, debris, and infected tissue that may be present. Additionally, critical structures within the epitympanum, which is the upper portion of the tympanic cavity, are addressed. This includes the removal of the head of the malleus and the body of the incus, which are important components of the middle ear. While the stapes, another ossicle in the ear, may also be removed during this procedure, efforts are made to preserve it whenever possible. The removal of these structures facilitates the exteriorization of the mastoid cavity and the middle ear, which is essential for effective treatment of the infection. To gain access to the petrous apex, the anterior wall of the ear canal is removed, and in some cases, the condyle of the mandible may be excised. The tensor muscle of the tympanic membrane is avulsed, and the tensor semicanal is opened to allow for better visualization and access. The surgical team carefully dissects the area between the carotid artery, the cochlea, and the dura mater of the middle fossa to visualize and remove the petrous apex. After all infected tissue has been thoroughly excised, the incisions are closed, and a drain may be placed to facilitate ongoing drainage, ensuring that any residual fluid can be effectively managed post-operatively.