ArticleCureus2024
Comparison of Post-auricular Soft Tissue and Post-auricular Soft Tissue With Autologous Bone Pate in Obliteration of the Canal Wall Down Mastoidectomy Cavity.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background The surgical management of chronic otitis media (COM) with squamous disease is canal wall down mastoidectomy (CWDM). Canal wall down procedures require the obliteration of the newly formed cavity to mitigate complications. Soft tissue flaps, including Rambo flap, Hong Kong flap, Palva flap, and inferior-based fascio-periosteal flap, as well as autologous bone pâté, have been the most successful and commonly used materials for obliteration over the past two decades. Although each flap has its advantages, the Palva flap is considered superior, primarily because of its ease of use and the simplicity of its design. In this study, we intend to evaluate the effectiveness of mastoid obliteration using autologous bone pate with Palva flap compared to Palva flap (post-auricular fibro-periosteal soft tissue) in patients who underwent CWDM. Methods Sixty-two patients with COM with squamous disease were included in the study. The patients underwent CWDM with tympanoplasty and meatoplasty, followed by cavity obliteration using two different methods: group A - obliteration with Palva flap (post-auricular fibro-periosteal soft tissue) and group B - obliteration with Palva flap and bone pate. The patients were evaluated for cavity problems on post-operative days 21, 30, 60, 90, and 180, based on a 10-point scale compiled from the literature. Results Our study found that the majority of patients had right-sided disease and were between 41 and 60 years of age. Five out of sixty-two (8.1%) patients developed cavity problems, three in group A (9.7%) and two in group B (6.5%). The incidence of cavity problems was almost the same in both groups. The cavity problems were as follows: vertigo (1/62, 1.6%), surgical site infection (2/62, 3.2%), and graft failure (2/62, 3.2%). However, there were no statistically significant differences (p-value: 0.62) between either of the obliteration methods in terms of mitigating cavity problems. Conclusion Post-auricular soft tissue and post-auricular soft tissue with autologous bone pate in the obliteration of the CWDM cavity provided similar results in terms of mitigating cavity problems.
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