Soft tissue technique in musculoplasty obliteration of mastoidectomy cavities.

Abstract

AbstractWhen properly performed musculoplasty is capable of producing a satisfactory canal reproduction and a high percentage of postoperative trouble free ears. Failure to obtain mastoid cavity obliteration with this procedure is due to improper preparation and placement of the soft tissue pedicles and does not represent a deficiency in the operation itself.A method of musculoplasty which evolved during the performance of 346 cases of this type of operation during the past 11 years is described in detail. The method is based upon the principles of an adequate incision; utilization of all available adjacent soft tissue for obliteration; sufficient mobility of the pedicle flaps to insure cavity adaptation; beveling of the cavity margins; “overfilling” of the mastoid defect; and, finally, fixation of the obliterative pedicles by suturing.Using this technique, the following results have been obtained: Eighty‐one percent trouble‐free postoperative cavities with a satisfactory canal reproduction rate of 68 percent. (Five or more years observation on 100 cases.) Where combined with tympanoplasty, utilizing a malleostapediopexy conductive repair, closure of the air‐bone gap to within 15 db was maintained in 65 percent of the cases. (Two or more years observation on 40 cases.) Postoperative occurrence of cholesteatoma has been limited to 2 percent residual and 1 percent recurrent. (Five or more years observation on 100 cases.)