title: Canal wall-down tympanoplasty with soft-wall reconstruction using the pedicled temporoparietal fascial flap: technique and preliminary results.
abstract: OBJECTIVE
  We compared the use of the pedicled temporoparietal fascial flap (TPFF) with the use of free deep temporal fascia (DTF) in soft-wall reconstruction after canal wall-down tympanoplasty.
  
  
  METHODS
  In the TPFF group (6 ears), the pedicled TPFF that includes the superficial temporal artery and vein was raised ipsilaterally and rotated into the eradicated mastoid cavity. The tympanic membrane and external auditory canal (EAC) were reconstructed by gluing one side of the TPFF to the mucosal layer of the tympanic membrane and the reverse side of the posterior EAC skin. In the DTF group (21 ears), reconstruction was performed similarly with free DTF. The postoperative period for epithelialization of the tympanic membrane and EAC skin, postoperative complications, and reaeration in the middle ear revealed by computed tomography were reviewed in both groups.
  
  
  RESULTS
  In the TPFF group, the mean (+/- SD) period to epithelialization was 25.5 +/- 2.8 days versus 38.4 +/- 12.0 days in the DTF group; the two groups differed statistically (Welch's t-test, p = 0.0002). No postoperative complications occurred in the TPFF group, whereas 2 patients in the DTF group underwent graft necrosis with infection. Three of the 6 patients in the TPFF group showed reaeration not only in the tympanic cavity, but also in the mastoid cavity. However, no statistical differences between the two groups were observed in terms of postoperative complications or reaeration of the mastoid cavity.
  
  
  CONCLUSIONS
  Our preliminary findings suggest that the pedicled TPFF has positive effects on quick epithelialization. Further prospective studies are needed to reveal the superiority of the pedicled TPFF over free DTF with regard to postoperative infection and recovery of mastoid aeration.
authors.affiliation: Dept of Otolaryngology, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan.
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Haginomori
authors.forename: Ryuzaburo
authors.initials: R
authors.lastname: Nonaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takenaka
authors.forename: Koichi
authors.initials: K
authors.lastname: Ueda
mesh_terms: D000328:Adult; D000368:Aged; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D004424:Ear Canal / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D013699:Temporal Arteries; D013997:Time Factors; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods*; D014945:Wound Healing