**2.3 Mastoidectomy posterior tympanotomy approach**

MPTA is performed using both the surgical microscope and otologic drill. Widening of the posterior tympanotomy in an inferior direction with removal of excess bone in front of the facial nerve is an essential step for good exposure of RW niche and membrane, taking care that RW membrane may be obscured by a false membrane (false RW membrane) that should be removed first by sharp instrument (**Figure 3**).
