Post-operative Healing and Long-term Stability After Mastoid Cavity Reconstruction Using the Middle Temporal Artery and Inferior Musculoperiosteal Flaps

Overview

Journal Eur Arch Otorhinolaryngol

Specialty Otorhinolaryngology

Date 2021 Feb 16

PMID 33590338

Citations 2

Authors

Arthur Dexian Tan

Jia Hui Ng

David Yong-Ming Low

Heng Wai Yuen

Affiliations

Soon will be listed here.

Abstract

Purpose: This study aims to evaluate the surgical outcomes with the use of a combination of the middle temporal artery (MTA) flap and the inferior musculoperiosteal (IMP) flap for mastoid obliteration after canal wall down mastoidectomy.

Methods: Seventy-five patients who have undergone canal wall down mastoidectomy and mastoid obliteration with the MTA and the IMP flaps at a single tertiary hospital were included. Surgical outcomes measured included the creation of a dry mastoid cavity as measured by a previously developed semi-quantitative scale, mastoid cavity epithelization time, rate of revision surgery needed, and rate of recurrent cholesteatoma.

Results: Patients were followed up for a median of 29 months. The median time to epithelization of the mastoid cavity was 2 months. At 1 and 3 months, 36.0% and 76.0% of patients had grade 0 and grade 1 cavities, respectively, with either a dry cavity or one or less episodes of mild otorrhea or sensation of wetness. Hundred percent of the patients achieved a grade 2 (more than one episode of otorrhea or the presence of granulation tissue that promptly resolved with simple treatment) or better cavity at 3 months. One patient re-presented with a grade 3 cavity with uncontrolled infection and daily otorrhea secondary to an attic perforation that manifested at 6 months, requiring revision surgery. There were no recurrent cholesteatomas during the follow-up period.

Conclusions: The use of the MTA and the IMP flaps for mastoid obliteration may be considered as an adjunct to achieving a safe, dry ear after canal wall down mastoidectomy.

Citing Articles

Concentrated growth factors promote epithelization in the mastoid obliteration after canal wall down mastoidectomy.

Liu M, Zhang L, Zhang Q, Zeng N, Li S, Guo S Braz J Otorhinolaryngol. 2025; 91(3):101561.

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Heterologous Materials Are Really Better than Autologous in Tympanoplasty Mastoid Obliteration? A Systematic Review with Meta-Analysis.

Viberti F, Monciatti G, Donniacuo A, Ferretti F, Salerni L, De Vito A J Int Adv Otol. 2024; 20(5):439-449.

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Allograft bone vs. bioactive glass in rehabilitation of canal wall-down surgery.

Fieux M, Tournegros R, Hermann R, Tringali S Sci Rep. 2023; 13(1):17945.

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