Comparative Evaluation of Mastoid Cavity Obliteration by Vascularised Temporalis Myofascial Flap and Deep Temporal Fascial-Periosteal Flap in Canal Wall Down Mastoidectomy.

INTRODUCTION: 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.

AIM: 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.

MATERIALS AND 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 90th day was clinically superior in patients of group 2 (85%) as compared to group 1 (75%). However, these difference were not statistically significant.

CONCLUSION: 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.