After mastoidectomy, and certain tympanoplasty procedure, the mastoid cavity often becomes a problem both to the patient and to the physician. Long periods of postoperative care are required, since incomplete healing with intermittent or continuous suppuration, and the necessity for repeated cleansing of epithelial debris from the caving are not unusual occurrences. For several decades otologists have attempted to find successful ways to eliminate this cavity after such operation. A meatally based postauricular musculoperiosteal flap(PALVA flap) is recommended for cavity obliteration in cases with open cavity mastoidectomy. A new rigid posterior canal wall is reconstructed using cortical bone dust between fascia and musculo-periosteal flap.