The Effect of Mastoid Obliteration Technique Using Superiorly Based Musculoperiosteal Flap and Autologous Conchal Cartilage

Kim, Haeng Jae; Shin, Myung Seok; Cho, Yong Bum; Cho, Yeon; Kim, Jung Hyun; Lee, Joon Kyoo

Abstract

BACKGROUND AND OBJECTIVES: The debate regarding the surgical technique for the management of open mastoid cavity still continues. In this study, we investigated the mastoid obliteration effect of superiorly based musculoperiosteal flap (SBF) with or without the combination of autologous conchal cartilage comparing with the well known Palva flap. MATERIAL AND METHOD: The 51 ears of 51 chronic otitis media or cholesteatoma patients who had been performed open cavity tympanomastoidectomy surgery with mastoid obliteration during the period from 1998 to 1999 were included in this study. Of the 51 ears, mastoid obliteration was performed using SBF and conchal cartilage in 25 ears, using SBF only in 18 ears and using the Palva flap in 8 ears. The duration of cavity epithelization and the increment of ear canal volume were compared among these three groups. The volume of ear canals and postoperative cavities were measured by filling the ear canals with sterile saline solution up to the cartilaginous part of the ear canal, starting at the level of tympanic membrane when the patient was lying on his side with the ear examined facing upward.
RESULTS
Analysis of the data showed significant differences among the three groups in either duration of cavity epithelization (SBF & cartilage: 76+/-20 days, SBF only : 85+/-18 days and Palva flap : 106+/-21 days) and increased rate of postoperative ear canal volume (SBF & cartilage : 72%, SBF : 102% and Palva flap : 171%).
CONCLUSION
The results of this study shows better outcomes in the groups of SBF & cartilge or SBF only compared with the group of Palva flap in terms of duration of cavity epithelization and increment of ear canal volume. Especially, SBF combined with autologous conchal cartilage achieves more favorable results. Thus, we suggest that the SBF & cartilage mastoid obliteration technique is one of the useful technique for the patients with open cavity tympanomastoidectomy.