soft posterior canal wall reconstruction with and without anteriorly based musculoperiosteal flap

this study was designed reevaluate the outcome of soft wall reconstruction technique for cwd mastoidectomy and to test the validity of anteriorly–based musculoperiosteal flap attachment without oblitrating the mastoid cavity for increasing graft viability. two methods of reconstruction were used. soft wall reconstruction method as described previously by smith et al, were performed on 35 patients (a) , and anteriorly – based musculoperiosteal flap was attached to it in 25 patients (b). post operative condition of meatal wall, graft failure and canal volume in two groups were documented. in 3 years follow up period no retraction pockets were documented and there was slight increase in canal volume measured by the volume of povidone iodine pouring in the canal. 17% of group a and 8% of group b had graft failure. no significant differences was seen (p > 0.05). there was no recurrent cholesteatoma in the patients on clinical examination. soft-wall reconstruction method is a safe method for eliminating the problem of radicalized mastoid cavity, and the musculoperiosteal flap attachment had no advantage compared with soft-wall reconstruction.