S214 – Temporal Fascial and Periosteal Flap in Tympanoplasty

Abstract

Objectives It is very important to maintain a stable reconstructed posterior canal wall with bone plate and cartilage in the posterior canal wall reconstructed tympanoplasty. We treat reconstructed posterior canal wall with the temporal fascial flap (TFF) and the temporal periosteal flap (TPF) to have a stable posterior canal wall and a tympanic membrane graft. We investigated the blood supplies of TFF and TPF to know the effectiveness of those flaps. Methods Retrospecyive analysis of a prospective patient data set. Tertiary care referral center. 25 patients with chronic otitis media underwent canal wall reconstructed tympanoplasty between December 2005 and December 2007. We employed Laser Doppler blood flowmeters to measure the blood supplies of TFF(F1: the tip and F2: the root) and TPF(P) during surgeries. The data were analyzed by Welch's t-test (p<0.05). Results The mean ± SD were F1:23.3±8.6 Flux?F2: 25.3±8.3 Flux and P:17.1±5.1 Flux in controls, and F1:21.1±4.2 Flux?F2:21.9±3.1 Flux and P:17.1±2.4 Flux in pedicled flaps, respectively. There were no significant statistical differences between controls and pedicled flaps, but were significant differences between TFF (F1 and F2) and TPF (P) (p<0.05). Conclusions These findings suggested that the TFF and TPF were reliable sources of local well-vascularized tissue to be extremely pliable and facilitate to create the stable posterior canal wall. Furthermore, it seems that it was linked to prompt postoperative healing, the avoidance of postoperative infection, the postoperative hearing improvement, the shorter hospitalization stay, and early discharge from the hospital.