Related Experiment Video
Updated: May 5, 2026
Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
Vascularized reconstruction of partial external auditory canal wall defects using the middle temporal artery flap
1Division of Otology and Neurotology, Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, U.S.A.
Objective:
To review indications and surgical outcomes for partial canal wall defect reconstruction using the middle temporal artery (MTA) rotational flap.
Study Design:
Retrospective review.
Setting:
Academic tertiary referral center.
Patient:
Adults that underwent attempted reconstruction of various partial canal wall defects with the MTA flap by a single surgeon.
Intervention(S):
Review of demographic data, defect etiology and location, operative technique, subject wound healing risk factors, and time/success of canal wall healing.
Main Outcome Measure(S):
Rate of complete canal wall healing/epithelialization by 8 weeks postoperation.
Results:
Eighteen cases were reviewed. Underlying canal wall pathology included the following: cholesteatoma, penetrating trauma, malignancy, osteonecrosis, and canal-mastoid fistula. In all cases, the canal wall was completely healed and epithelialized by 8 weeks postoperation, and there were no flap-related complications. Many cases (56%) involved previous intact-canal wall mastoidectomy surgery in the past with apparent degeneration of thinned canal wall bone. In 2 cases, the MTA pedicle had been violated by previous surgery; however, a smaller vascularized flap based on remnant blood supply was successfully used in each instance.
Conclusion:
The MTA flap is useful as a thin, pliable flap that can be applied for reconstruction of various partial canal wall defects. This technique may be particularly useful in the settings of osteonecrosis and chronic infection where introduction of vascularized canal wall lining is particularly desirable. Although short-term outcomes are encouraging, the long-term outcomes of this technique are unknown.
