The vertical juxtaposition junction (VJJ) flap is a useful adjunct to the technique of mastoid obliteration and is readily created during the process of cartilage graft harvesting from the conchal bowl.
It allows for greater inward rotation of a Palva flap into the mastoid cavity; provides a platform for overlying soft tissues, thus helping to prevent their prolapse into the cavity over time; through tension, helps to stent the external auditory meatus.
Long term results suggest that is helps to better contour the obliterated cavity and thus may aid in better epithelial migration within the reconstructed ear.
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