Cavity Filling Technique in Mastoid Surgery

Abstract

A method for reducing the size of the operation cavity in modified radical and radical mastoid operations is described. Two stilated flaps are used, a postauricular and a meatal flap. The postauricular flap is skin-lined and includes also thick subcutaneous tissue. The distal part of the meatal flap consists of subcutaneous tissue without any epidermis. In order to avoid the recurrence of cholesteatoma in a filled operation cavity, neither flap is placed over that part of the operation cavity where cholesteatoma has been observed. In many cases the ultimate operation cavity is only a small extension of the medial upper part of the auditory canal. In those cases, too, where the primary operation cavity is very large, the final result is an operation cavity without any recesses posteriorly, laterally and distally. The cavity is lined with real skin, which has no increased tendency towards desquamation. Therefore, periodic inspection and cleaning of the cavity can be utterly reduced. The thick postauricular flap can also be used for revision of a discharging operation cavity, resulting from a previous operation by a different method. Furthermore, it is useful in cases of prolapse of the dura and for covering a lesion of the sinus.