External Auditory Canal Reconstruction and Mastoid Obliteration Using Modified Palva Flap in Canal Wall Down Mastoidectomy With Tympanoplasty

Objective: To evaluate the effectiveness of a modified Palva flap used for external auditory canal reconstruction and mastoid obliteration in canal wall down mastoidectomy. Methods: We retrospectively analyzed patients who underwent canal wall down mastoidectomy with tympanoplasty using modified Pal...

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Bibliographic Details
Published in:Annals of otology, rhinology & laryngology rhinology & laryngology, 2019-06, Vol.128 (6_suppl), p.69S-75S
Main Authors: Kim, Ji-Sun, Lim, Il Gye, Oh, Jeong-Hoon, Kim, Byung Guk, Chang, Ki-Hong
Format: Article
Language:English
Subjects:
Adult
Aged
Audiometry, Pure-Tone
Chronic Disease
Ear Canal - surgery
Female
Humans
Male
Mastoid - surgery
Mastoidectomy - methods
Middle Aged
Otitis Media - surgery
Reconstructive Surgical Procedures - methods
Retrospective Studies
Surgical Flaps
Treatment Outcome
Tympanoplasty - methods
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Summary:Objective: To evaluate the effectiveness of a modified Palva flap used for external auditory canal reconstruction and mastoid obliteration in canal wall down mastoidectomy. Methods: We retrospectively analyzed patients who underwent canal wall down mastoidectomy with tympanoplasty using modified Palva flap. All patients underwent pure tone audiometry and temporal bone computed tomography (CT) before surgery, and the same tests were performed in the first year after surgery. The external auditory canal volumes were calculated by summing the areas of each section selected in temporal bone CT. For each patient, the ratio of external auditory canal volume was calculated from CT taken before and after surgery. Results: The mean of external auditory canal volume after canal wall down with a modified Palva flap was about 1.4 times larger than before surgery. The modified Palva flap is effective for the reconstruction of the external auditory canal. Both pure tone audiometry level and air-bone gap showed statistically significant improvement after surgery (Ps = .001 and .002, respectively). Conclusions: The external auditory canal volume slightly increased, but the status of mastoid obliteration was well maintained 1 year after surgery. The modified Palva flap used in this study is an easy and effective method in external auditory canal reconstruction and mastoid obliteration.
ISSN:0003-4894
1943-572X
DOI:10.1177/0003489419836228