Surgical Outcomes of Mastoid Cavity Obliteration Using Postauricular Composite Bone with Periosteum Flap Following Canal Wall Down Mastoidectomy

Background: Canal wall down (CWD) mastoidectomy remains a reliable surgical technique for eradicating cholesteatoma in chronic suppurative otitis media (CSOM). However, the resulting open mastoid cavity is frequently associated with long-term morbidity such as persistent otorrhea, debris accumulation, vertigo, and difficulty in hearing aid use. Mastoid cavity obliteration has been advocated to overcome these drawbacks and improve postoperative outcomes. Objectives: To evaluate the surgical and hearing outcomes of mastoid cavity obliteration using a postauricular composite bone with periosteum flap following CWD mastoidectomy in patients with CSOM. Materials and Methods: This prospective study included patients with atticoantral type CSOM undergoing CWD mastoidectomy with mastoid cavity obliteration using a postauricular composite bone?periosteum flap. Patients were followed up clinically and audiologically. Surgical outcomes were assessed based on cavity status, epithelialization, presence of otorrhea, and complications. Hearing outcomes were evaluated using pure tone audiometry. Results: Most patients achieved a well-epithelialized, dry, and self-cleaning mastoid cavity. A significant reduction in postoperative cavity-related problems was observed. Audiological assessment demonstrated improvement in air-bone gap in a substantial proportion of patients. Conclusion: Mastoid cavity obliteration using a postauricular composite bone with periosteum flap following CWD mastoidectomy is an effective technique that reduces cavity-related morbidity while providing satisfactory hearing outcomes.