This paper reports a new procedure used successfully in the reconstruc
tion of 12 radical mastoid cavities in King Fahd Hospital of the Unive
rsity, Al-Khobar, Saudi Arabia. A composite pedicled flap composed of
temporalis muscle and its fascia attached along one border, based post
eriorly, is rotated in to the radical cavity. The muscle is used to ob
literate the cavity and the fascia is hinged forward as a tympanic mem
brane graft.