The use of vascular flaps in middle ear surgery.
OBJECTIVE
This study aimed to evaluate improved surgical outcomes from middle and external ear surgery using local vascular flaps to enhance tissue healing.


METHODS
The study design was a review of the design and clinical trials of three soft tissue flaps: the middle temporal flap (MTF), the middle temporal canal flap (MTCF), and the wing flap. All derive axial vascular supply from the middle temporal vessels.


METHODS
The study was performed at a single surgeon's private otologic practice.


METHODS
A total of 319 patients were treated from 1991-1996: MTF in 223, MTCF in 38, and wing flap in 58. The average case maturity was 2.25 years. Most cases were mastoidectomy reconstruction or intact canal wall mastoidectomy.


METHODS
The flaps are used to introduce an improved blood supply to key repair sites in the middle and external ear.


METHODS
Canal skin breakdown, chronic myringitis, and chronic otitis externa were measured.


RESULTS
Dehiscence rates fell from 15-5% and myringitis rates fell from 15-4%. Thicker, vascular canal skin was the usual result.


CONCLUSIONS
The flaps provide the optimal method of revascularizing the external canal during mastoidectomy reconstructions and possibly canal defect repairs during intact canal wall mastoidectomy. Further studies are required to evaluate the efficacy of the wing flap and the MTCF.
Black
B
B
Department of Otolaryngology, Royal Children's Hospital, Brisbane, Queensland, Australia.
D004432:Ear, Middle / Q000637:transplantation*; D006801:Humans; D013524:Surgical Flaps; D013699:Temporal Arteries / Q000601:surgery*