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Mastoid Obliteration and Reconstruction: A Review of Techniques and Results

The aim of cholesteatoma surgery is to obtain a safe, dry and self-cleaning ear. Several methods have been tried and tested to achieve this goal with varying degrees of success. This article reviews some of the more common methods for mastoid reconstruction and obliteration and their results. Current trends appear to favour a combination of mastoid obliteration and reconstructive techniques, with biologic materials such as muscle flaps and bone chips preferred over non-biologic materials such as hydroxyapatite crystals and ceramic. However, there is large variation among the type of biologic flap used, which can vary between fascia, muscle and periosteum. After an extensive review, there is no ideal method for mastoid obliteration and reconstruction, as most methods appear to have a certain degree of success. The basic principles of a low facial ridge, large meatoplasty and an oval mastoid cavity should be adhered to, and the surgeon should choose a method that he or she is comfortable with.