MEATOPLASTY THROUGH AN ENDAURAL APPROACH
R. Gomez-Ullate, F. Cristobal, A. Arcocha, A. Lirola, A. Machado
ENT Dept. “Pabellon 8” Hospital de San Carlos
Madrid-Spain
INTRODUCTION AND OBJECTIVE: The object of this study is to show our experience with a new kind of endaural meatoplasty. The auricular meatoplasty was described by Viennese otologist in the late nineteenth century. A hundred years later this procedure remains necessary in every open mastoidectomy.
Most surgeons prefer to perform the meatoplasty, following our classics, through a retroauricular incision. However, we have developed a new method of meatoplasty by an endaural approach similar to those described by Osborne, Farrior and Fleury, but performed at the beginning of the surgery.
The advantages of this procedure is that the size and shape of the cartilage to be removed are very easily calculated. Therefore we are able to predict the width of the future external auditory canal.
MATERIAL AND METHODS: 227 meatoplasties by endaural approach have been performed in the last six years, most of then being a step in an open mastoidectomy. Two parameters are considered in order to evaluate the results: the mastoid cavity stability and eardrum state.
RESULTS: Only three (1.4%) ears out of 223 remained unstable after three years and five (2.24%) continue with a perforation of the eardrum.
CONCLUSION: The endaural approach meatoplasty allows us to design with great precision the size and shape of the conchal cartilage to be removed. The volume of the future external canal can be therefore calculated. The cartilaginous conchal fragment can be removed in whole with no tires, and attached to its perichondrium. This piece will be very valuable in order to reconstruct parts of middle ear or the mastoid. The meatoplasty performed at the beginning of the surgery allows a wide exposure of the mastoid.