S225 – A New Meatoplasty Technique in Canal Wall Down

Abstract

Objectives

Although it is well recognized that a small meatus after canal wall down tympanomastoidectomy can cause a lifetime problem, unsatisfactory results are frequently encountered. We introduce a new technique to maintain a large external auditory meatus, reduce the mastoid dead space, and improve the posterior auricular cosmetics outcome.

Methods

From Jan 2005 through Dec 2006, 39 ears had undergone canal wall down tympanomastoidectomy with the perichondreial posterior fixation technique. 2 stitches were made to pull the perichondrium of the canvun conchal cartilage posteriorly to the periostium of the mastoid bone. Medical records were retrospectively reviewed for the postoperative complications, including infection. Postoperative size of the meatus and the extent of cavum conchal cartilage burying into the mastoid cavity were evaluated by taking digital photographs.

Results

15 males and 24 females were included; the mean age was 54 years (37yr-66yr). The postoperative follow-up duration was 9.5 months (6mo-23mo) in average. All the ears maintained a clean and large external meatus. The posterior auricular cavum conchal cartilage was successfully prevented from being buried into the mastoid cavity in all the ears. The extent of burying was much improved compared to the conventional technique. 2 ears (5%) had a very mild postoperative inflammation but it was easily controlled by topical antibiotics.

Conclusions

The perichondreial posterior fixation, which is a new meatoplasty technique in canal wall down tympanomastoidectomy, seems to be effective in maintaining a large external auditory meatus and improving the cosmetic outcome with minimal risk of complications.