title: Obliteration of the persistently discharging mastoid cavity using the middle temporal artery flap.
abstract: OBJECTIVE
  To evaluate the surgical outcome of patients undergoing obliteration of a persistently discharging mastoid cavity with specific soft tissue vascular flaps for chronic otitis media or cholesteatoma.
  
  
  METHODS
  A five-year retrospective consecutive case review in a tertiary care referral center. Following mastoidectomy obliteration with a superiorly based middle temporal artery, axial periosteal flap and inferiorly based random pedicled musculoperiosteal flap was performed. The primary outcome was control of suppuration and the creation of a dry, low-maintenance cavity as assessed by a semi-quantitative scale.
  
  
  RESULTS
  A total of 51 consecutive patients undergoing revision mastoidectomy with obliteration were identified with a minimum follow-up of 12 months; 43 (84%) had a small dry healthy mastoid cavity; three ears (6%) had occasional otorrhea that was relatively easily managed by topical therapy.
  
  
  CONCLUSIONS
  Obliteration using the middle temporal artery and inferior random flaps is an effective method to manage patients with pre-existing cavities and also those not previously operated upon.
authors.affiliation: Department of Otolaryngology, St. Michaels Hospital, Bristol, United Kingdom. viv_s@hotmail.com
authors.forename: Vivian
authors.initials: V
authors.lastname: Singh
authors.forename: Marcus
authors.initials: M
authors.lastname: Atlas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D010033:Otitis Media / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000379:methods*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D013524:Surgical Flaps; D013699:Temporal Arteries; D016896:Treatment Outcome