An early mastoid cavity epithelialization technique using a postauricular pedicle periosteal flap for canal wall-down tympanomastoidectomy.
CONCLUSIONS
Most ears that were treated with a new surgical method were rendered dry and safe, with cavity problems minimized by this simple technique. This technique is also valid in terms of medical economy because it shortens the hospitalization period and subsequent outpatient care is not required frequently.


OBJECTIVE
Canal wall-down tympanomastoidectomy was a well established procedure for severe chronic otitis media, especially cholesteatoma. However, this procedure has some defects, so-called cavity problems, caused by non-epithelialized bony wall. The aim of this study was to evaluate the early epithelialized technique for the surface of widely formed external acoustic meatus after canal wall-down tympanomastoidectomy.


METHODS
Twenty-five patients who had been diagnosed with cholesteatoma were divided into two groups. Group I consisted of 15 patients who underwent a new method in which the open cavity was lined with a pedicle periosteal flap of the postauricular region together with free temporal fascia grafts. As a control, 10 patients in group II underwent the standard operation that uses only free temporal fascia grafts.


RESULTS
A comparison of the two groups showed that it took only 1 month on average for the entire surface of the external auditory meatus of the patients in group I to epithelialize and dry up perfectly, although the same area in all the patients in group II was not dried up perfectly until over 80 days.
Kanemaru
Shin-Ichi
S
Department of Otolaryngology-Head and Neck Surgery, Medical Research Institute, Kitano Hospital, Osaka. kanemaru@ent.kuhp.kyoto-u.ac.jp
Hiraumi
Harukazu
H
Omori
Koichi
K
Takahashi
Haruo
H
Ito
Juichi
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D015331:Cohort Studies; D004424:Ear Canal / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D010521:Periosteum; D013524:Surgical Flaps; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods*; D055815:Young Adult