Figure 4: An example of intraoperative view of left cortical mastoidectomy showing sigmoid sinus (1). The patient is positioned supine with head turned to right. The patient is undergoing left lateral temporal bone resection, total parotidectomy, mandible resection, left neck dissection and reconstruction for malignancy. The left internal jugular vein has been ligated in the upper neck (2). The external auditory canal has been excised along with removal of the tympanic membrane and middle ear contents followed by obliteration of the middle ear with fat and gel foam (3). The glenoid or mandibular fossa can be seen clearly (4).