Skin incision
01. Fascia cut
02. Musculofascial flaps
03.Osteoplastic mastoidectomy
04. Mastoid exposure
05. Incus and mastoid antrum
06. Labyrinth
07. Jugular bulb
08.Combine petrosal approach with flap
09.Middle meningeal artery and middle fossa floor
10.Kawase approach
11.Facial nerve segments
12.Carotid artery
13.Closure of the combined petrosal approach