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When the mastoid cavity infection is the result of breakdown of the skin lining, the cavity should be obliterated. Many types of material have been used, but postauricular tissue has been most effective. Instead of a pedicled flap, a free graft of tissue is recom mended because it allows better placement of the graft deep into the cavity. It un dergoes a more uniform contracture and does not tend to pull out of the depths of the cavity. The principle of obliteration is not only to obliterate the cavity but also to bring a layer of vascularized subcutaneous tissue between the skin lining and the bone.

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