![]() It is placed in the cavity with a broad pedicle along the mastoid tegmen.įig. The flap has a broad base anteriorly ( Fig. If a canal wall–down mastoidectomy has been performed, then a large temporalis muscle flap with the fascia and the periosteum is elevated. The perforation is closed with a free fascial graft, and the ear canal flap is returned. ![]() If only an atticotomy or a small atticoantrotomy is performed, a small muscle flap is used ( Fig. After posterior retraction of the auricle, the temporalis muscle fascia is exposed ( Fig. After an endaural incision including a vertical extension 1 cm superior to the helix of the auricle, a laterally-based ear canal skin flap is elevated, exposing the posterior bony ear canal and the mastoid process ( Fig. The skin incision will be sutured, maintaining a wide ear canalįreerichs and Williams (1962) modified the Rambo technique in order to obliterate the mastoid cavity with temporalis muscle. 875 The laterally-based skin flap is replaced, partly covering the muscle and partly the cavity wall. ![]() The Rambo method was often used in fenestration operations, and rapid healing of the cavity was often the case ( Fritz and Crawford 1960).įig. In subsequent years, Rambo detached the drum from the malleus handle and elevated it laterally together with the annulus and ear canal skin ( Rambo 1969). Rambo never used the muscle to fill the cavity, but the muscle contributes with its vascularity to healing and is a vascular support for skin flaps. The major part of the cavity wall is not covered with muscle. The canal skin flaps are returned, and the free flap of canal skin is replaced, partly covering the muscle flap and partly covering the bone of the cavity ( Fig. A larger flap will cover the tympanic cavity, the attic, and the medial wall of the antrum ( Fig. A flap of the temporalis muscle with its fascia is cut, and it is turned down over the mastoid tegmen into the cavity to cover the drum remnant, the attic, and the medial wall of the aditus ad antrum ( Fig. A conservative radical cavity is created, with extensive removal of air cells ( Fig. ![]() The conchal skin is elevated, creating an anterior and an inferior skin flap, and exposing the entire bony ear canal. 866), a large area of the temporalis muscle fascia is exposed. The aim of the flap was to bridge the tympanic cavity and restore hearing.Īfter a special endaural incision, extending posterosuperiorly to the upper edge of the auricle ( Fig. Rambo (1957) described a method of covering the tympanic cavity and the medial antrum wall with a superoanteriorly-based flap of temporalis muscle. In the early 1930s, Mill (1931) and Kisch (1932) used a temporal muscle flap in an attempt to obliterate the mastoid cavity and retain an external auditory canal. Flaps consisting partly or mostly of retroauricular subcutaneous fibrous tissue and muscle with its periosteum can be superiorly based, and several obliteration techniques have been described in endaural and retroauricular approaches. Such flaps are usually sufficient to obliterate the upper part of the cavity. The superiorly-based flaps usually consist of the temporal muscle, elevated together with the periosteum and the temporalis muscle fascia, and they are turned down into the cavity. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |