Osteoradionecrosis of the external auditory canal: three cases involving reconstruction with transposition of a split temporalis muscle flap

Pedicled Temporalis Muscle Flap Stuffing after a Lateral Temporal Bone Resection for Treating Mastoid Osteoradionecrosis

Objective The aim of this study was to compare the outcomes of lateral temporal bone resection and pedicled temporalis muscle flap stuffing with external auditory canal closure with those of canal wall down mastoidectomy for the treatment of mastoid osteoradionecrosis. Study Design Prospective nonrandomized case-control clinical study. Setting Department of Otolaryngology of the First People's Hospital of Foshan. Subjects and Methods Seventy-seven postirradiation nasopharyngeal carcinoma patients with mastoid osteoradionecrosis were included. Forty patients (40 ears) underwent lateral temporal bone resection in the temporalis muscle flap group. Their pedicled temporalis muscle flaps were laid on the surgical cavity, and the external canal opening was simultaneously closed. Thirty-seven patients (37 ears) underwent a canal wall down mastoidectomy in the mastoidectomy group. The surgical wounds and complications following surgery were retrospectively analyzed. Results The patients were followed for 2 years. The percentage of patients with purulent otorrhea and persistent osteoradionecrosis in the temporalis muscle flap group was lower than that in the mastoidectomy group. Conclusion Our preliminary results suggest that lateral temporal bone resection with the pedicled temporalis muscle flap filled into the surgical cavity, followed by closure of the external auditory canal, represents a valuable approach for treating mastoid osteoradionecrosis.