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Updated: Jul 12, 2026
Endaural Endoscopic Atticoantrotomy (Retrograde Mastoidectomy) using a Constant Suction Bone-drilling Technique
Published on: May 23, 2021
Obliteration of the persistently discharging mastoid cavity using the middle temporal artery flap
1Department of Otolaryngology, St. Michaels Hospital, Bristol, United Kingdom. viv_s@hotmail.com
Objective:
To evaluate the surgical outcome of patients undergoing obliteration of a persistently discharging mastoid cavity with specific soft tissue vascular flaps for chronic otitis media or cholesteatoma.
Study Design:
A five-year retrospective consecutive case review in a tertiary care referral center. Following mastoidectomy obliteration with a superiorly based middle temporal artery, axial periosteal flap and inferiorly based random pedicled musculoperiosteal flap was performed. The primary outcome was control of suppuration and the creation of a dry, low-maintenance cavity as assessed by a semi-quantitative scale.
Results:
A total of 51 consecutive patients undergoing revision mastoidectomy with obliteration were identified with a minimum follow-up of 12 months; 43 (84%) had a small dry healthy mastoid cavity; three ears (6%) had occasional otorrhea that was relatively easily managed by topical therapy.
Conclusion:
Obliteration using the middle temporal artery and inferior random flaps is an effective method to manage patients with pre-existing cavities and also those not previously operated upon.
