SURGICAL TECHNIQUE 

After administration of local anesthetic with vasoconstrictor medication, an incision is made at the fundus of the external auditory canal at 12 o’clock, which is radial extended towards the root of the helix where the incision turns backwards 90 degrees in direction to the concha, approximately 1.5 to 2 cm without overpass the anthelix  (fig. 1).

The incision must include the full thickness of the auricular tissue in the external auditory canal ( where it is thin ) as well as in the auricular segment ( area of maximum thickness ). By this technique a mixed ( skin and cartilage ) triangular flap with inferior and lateral base is achieved.  (fig. 2).

The flap is then rotated in a posterior and inferior direction and fixed to the digastric muscle that was exposed during the mastoidectomy using non-absorbable sutures. (fig. 3) An ambrose mould is placed in the new meatus and will be removed two weeks later. The patient is going to be followed for 12 weeks until a complete healing is achieved. ( Photo 1).

fig. 1

fig. 2

fig. 3

Photo 1

CONCLUSION

The main difference of this technique consist in the absence of conchal cartilage removal and the need of only one incision which makes the surgical procedure easier, with less morbidity and with a shorter recovery and healing process time.

Likewise, an appropriated size of meatoplasty is obtained which is aesthetic acceptable for the patient. The results achieved are similar to those obtained with the other conventional techniques for meatoplasty.

BIBLIOGRAPHY

 1.Wormald  P, Van Hasselt C, Andrew FCS. A Technique of Mastoydectomy and  

Meatoplasaty that Minimizes Factors Associated with a Discharging Dastoid Cavity.

Laryngoscope 1999;109:478-82. 

2.Fisch U, Chang P, Linder T. Meatoplasty for Lateral Stenosis of the External  

Auditory Canal. Laryngoscope 2002;112:1310-14. 

3.Mirck P. The M – Meatoplasty of the External Auditory Canal. Laryngoscope  

1996;106:367-9. 

4.Murray D, Jassar P, Lee MS. Z-Meatoplasty Technique in Endaural Approach  

Mastoidectomy . J laryngol Otol 2000;114(7):526-8.

5.Paparella M, Meyerhoff W. Meatoplasty. Laryngoscope1978;88:357-60.