A surgical procedure different from the open or closed technique is presented. The attic is emptied through the meatus after a retromeatal access to the antromastoidal cavities. By blocking the aditus ad antrum, the procedure produces an antrio-attic microcavity with no recessus. Results of resection of epidermal lesions are quite satisfactory with a low rate of residual pathology. Retraction pouches do not develop because the mastoid is excluded and no attic recessus is formed. Surveillance of the cavity is easy and the disadvantages of functional sequellae inherent in open techniques are avoided. The preliminary results would confirmed the quality of the procedure. In 22 cases, there were 3 residual perles on the windows and 2 retraction pouches (anterior and posterosuperior). This technique is indicated in precholesteatoma states with poor prognosis and cholesteatomas of the attic. For more advanced lesions, this technique is less reliable and the open procedure is required.