The meatally based musculoperiosteal flap in cavity obliteration.

A meatally based musculoperiosteal flap that was formed for radical mastoid cavity obliteration was deliberately excised during revision surgery in three cases of recurring tympanic cholesteatoma. The flaps, which contained subcutaneous connective tissue, were well vascularized and contained large, viable muscle bundles and many nerve trunks from the postauricular branch of the facial nerve. In two cases, the periosteum-attached bone chips that had been removed from the patient's mastoid tip region and implanted to form a new bony canal wall were viable and gave the intended support for the meatus after radical ear surgery.