The dissections were performed in a step‐wise manner from the lateral direction. Bone dissection was performed using a Midas Rex drill (Medtronic, Fort Worth, Texas). The arteries and veins were perfused with red‐ or blue‐colored silicone rubber, Thinner 200, and RTV catalyst (all Dow Corning, Midland, Michigan), and dissected under ×3 to ×40 magnification. Three adult cadaveric heads were used to examine the soft tissue layers in the mastoid region. This study was approved by Kyushu University Institutional Review Board for Clinical Research (#28‐346). Use of these pictures was permitted by The Rhoton Collection. Rhoton Jr.’s laboratory at the University of Florida. In this study, all cadaveric dissections were performed by first author in the late Dr. We then described a case illustrative of the effectiveness of the mastoid fascia for otologic surgery, which demonstrates that flaps of the mastoid fasciae can be used to promote epithelialization after canal wall down mastoidectomy. In this study, we carried out a detailed investigation of the anatomical structure of the soft tissue layers in the mastoid region. A comprehensive understanding of this region is required to improve otologic reconstructive surgery. However, the soft tissue layers in the mastoid region and its continuity to the adjacent area remain unclear. Development of surgical skills and the understanding of soft tissue layers has provided a variety of local soft tissue flaps to promote wound healing and reduce surgical defects. 9, 10, 11 This technique is frequently used for otological surgery. 1, 2, 3, 4, 5, 6, 7, 8 Otorhinolaryngologists often use the postauricular soft tissue for temporal bone surgery, the most popular method being the palva flap, a musculoperiosteal flap based on the concha of the auricle. The fascial layers of the postauricular lesion (mastoid region) have been studied extensively.
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