Clinical Effect Analysis Of Reconstruction Of Mastoid Cavity With Periosteum Flap Of Posterior Auricular Muscle Abstract

Objective:To investigate the clinical effect of reconstruction of gas-filled mastoid cavity with mastoid periosteal flap in radical mastectomy and tympanoplasty.Methods: A total of 61 cases(64 ears)of chronic suppurative otitis media or middle ear cholesteatoma were treated with transpositional wall papillae radical mastectomy and tympanoplasty in our department of otolaryngology.After removal of the lesion,Closed the mastoid incision to form gas-filled mastocarcinoma,observe the postoperative dry ear situation,tympanic membrane healing,the level of hearing improvement,intraoperative cavity imaging data,summarizes the main points of surgical skills and postoperative efficacy.Results: All the 61 cases(64 ears)were operated successfully.The lesions were completely removed and the normal anatomy of the posterior wall of the external auditory canal was preserved.Most of the patients improved their hearing.The mean pure tone air conduction(AC)in the affected ears decreased from 58.13 ± 18.80 dBHL preoperatively to 40.98 ± 17.28 dBHL postoperatively.The airbone gap(ABG)decreased from 27.50 ± 10.51 dBHL preoperatively to 16.08 ± 11.62 dBHL postoperatively.Postoperative AC and ABG were significantly lower than before surgery(P <0.05).To improve the hearing after ossicular chain reconstruction success rate for the postoperative ABG <20dBHL,this group of patients with hearing improvement rate of 70.31%(45/64 ears).After 6months to 24 months follow-up,61cases(64 ears)of the tympanic membrane healed completely and the healing rate of tympanic membrane perforation was 100%.And all received dry ear,dry ear time10-30 days,the average dry ear time was 15 days;transplantation temporal fascia healing well,reconstruction of the eardrum 5 ears slightly invaded,poor activity.All patients had no damage to the inner ear,facial nerve injury or other complications,and no recurrence.Conclusion:In the complete wall mastoidectomy and tympanoplasty,the posterior endofacial flap is used to seal the mastoid cavity and prevent the growth of the posterior ear scar.The air cavity of the middle and upper tympanic cavity and mastoid is reconstructed.It is the middle ear Ideal for mastoid surgery.