Rehabilitation of the chronically discharging mastoid cavity is a problem which has faced otologists since the first radical mastoidectomy was performed. The literature abounds with methods of treatment by painting, powdering, disinfecting, or otherwise temporarily modifying the status of the mastoid bowl. Careful study has revealed that the most probable cause of these effects is the inadequacy of the blood supply to the skin lining the mastoid cavity. The intent of this paper is to describe a method of creating a good blood supply through the use of a pedicle muscle flap combined with vein-graft tympanoplasty to secure total rehabilitation of the patient who has previously undergone radical mastoid surgery.
The first reference to the use of a pedicle muscle flap is by Professor Doctor Passow1 who, in 1908, described a technique to close fistulas in mastoid cavities. He used periosteum from the temporalis area with attached muscle fragments.
AUSTIN DF, SANABRIA F. Mastoidplasty. Arch Otolaryngol. 1962;76(5):414–421. doi:10.1001/archotol.1962.00740050426006