Postauricular incision used for elevation of anterior musculoperiosteal flap and identification of the facial nerve is marked out. The incision is extended into the neck for exposure of the great vessels and cranial nerves. The upper limb of the incision is marked out for temporalis muscle mobilization if needed after the procedure

Anteriorly based mastoid musculoperiosteal flap is raised and left attached to the catalagenous canal to be used later for obliteration of the mastoid cavity

Neck dissection is done and the facial nerve identified. The facial nerve is dissected into the parotid gland postauricularly and up to the point of second division. The sternocleidomastoid muscle is retracted posteriorly and common carotid artery, internal jugular vein and vagus nerve identified. Cranial nerves XI and XII are also identified. Total parotidectomy is done. The tympanic segment of the facial nerve is removed as it is involved by the tumor. Radical mastoidectomy is done