title: Comparative Evaluation of Mastoid Cavity Obliteration by Vascularised Temporalis Myofascial Flap and Deep Temporal Fascial-Periosteal Flap in Canal Wall Down Mastoidectomy.
abstract: BACKGROUND
  A consensus is emerging amongst otologists that obliteration of the mastoid cavity that results after modified radical mastoidectomy is a sound option to prevent cavity related problems such as otorrhoea, infection, granulation tissue and hearing loss. A variety of techniques have been proposed to perform the obliteration.
  
  
  OBJECTIVE
  The present study aimed to compare the conventional method of mastoid cavity obliteration by vascularised temporalis myofascial flap with deep temporal fascial-periosteal flap in canal wall down mastoidectomy.
  
  
  METHODS
  The prospective study (conducted between July 2012 and August 2013) randomly assigned patients with evidence of attico-antral disease to two groups (20 in each group). After canal wall down mastoidectomy, a superior based vascularised temporalis myofascial flap was used to obliterate the resultant mastoid cavity in group 1 patients and an inferior based deep temporal fascial-periosteal flap was used in group 2 patients for the cavity obliteration. They were then followed up till day 90.
  
  
  RESULTS
  Cavity obliteration was better in group 2 (90%) as compared to group 1 (80%). Similarly, the final status of epithelisation of cavity at 90thday was clinically superior in patients of group 2 (85%) as compared to group 1 (75%). However, these difference were not statistically significant.
  
  
  CONCLUSIONS
  The clinical superiority of the results with temporal fascial-periosteal flap can be attributed to less frequent complications (partial obliteration and epithelisation of resultant mastoid cavities, residual perforation and persistent ear discharge) as compared to myofascial flap.
authors.affiliation: Senior Resident, Department of ENT and HNS, Post Graduate Institute of Medical Education and Research , Chandigarh, India .
authors.forename: Navjot
authors.initials: N
authors.lastname: Kaur
authors.affiliation: Associate Professor, Department of ENT, Government Medical College , Amritsar, Punjab, India .
authors.forename: Dinesh Kumar
authors.initials: DK
authors.lastname: Sharma
authors.affiliation: Professor, Department of ENT, Government Medical College , Amritsar, Punjab, India .
authors.forename: Jagdeepak
authors.initials: J
authors.lastname: Singh
keywords: Antrostomy; Mastoid infection; Obliteration