1978 年 21 巻 3 号 p. 323-327,236
Obliteration of the post-radical mastoidectomy cavity with muscle flap has been performed in cases, with persistent drainage and sensorineural hearing defect.
The procedure is done through a postauricular incision by obtaining a superiorly based large muscle.flap including the temporal and sternocleid mastoid muscles.
The mastoid cavity and middle ear are thoroughly exenterated by drilling, and then the ossicles are removed except the stapes. The external canal skin is elevated and reflected. The mastoid cavity, middle ear and the external canal are filled with the muscle flap. At the same time, the orifice of the eustachian tube is obstructed. The reflected canal skin is now put back in place and sutured primarily, leaving a drain in the postauricular incision.
The operation wound usually becomes dry in about two weeks. The authors performed 10 such operations resulting in healing up to 5 years in 9 cases. One case developed cholesteatoma. The important procedure in this technique seems to be to obstruct the orifice of the eustachian tube completely and to preserve and replace the canal skin over the muscle flap.