Canal reconstruction and mastoid obliteration using floating cartilages and musculoperiosteal flaps.

OBJECTIVES

To reduce the mastoid cavity-associated problems secondary to canal wall down mastoidectomy, we designed a new surgical procedure that includes canal wall reconstruction using free-floating cartilages and double musculoperiosteal flaps.

STUDY

DESIGN

Retrospective study.

MATERIALS AND

METHODS

Thirty-three patients were enrolled in this study. Preoperative and postoperative pure tone audiometry/speech discrimination score and postoperative status (complications and EAC status) were analyzed.

RESULTS

Air conduction thresholds were statistically improved (P = 0.008). The air-bone gap was significantly reduced following surgery (P = 0.001). There were no other major complications in any of the patients. Long-term follow-up demonstrated gradual widening of the neo-EAC in 18 patients (54.5%) but normal contour of the neo-EAC in the other 13 patients (39.4%). In just one case did the neo-EAC become extremely widened.

CONCLUSION

Mastoid obliteration and canal wall reconstruction using free-floating cartilages and double musculoperiosteal flaps is very useful to achieve optimal surgical view, eliminate the middle ear pathology, and prevent recurrence of cholesteatoma and cavity problem.

LEVEL OF EVIDENCE: 4. Laryngoscope, 127:1153-1160, 2017.