A Novel Technique of Reduction Meatoplasty for Correction of Very Large Meatus from a Previous Canal Wall-Down Mastoidectomy.
Journal
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
ISSN: 1537-4505
Titre abrégé: Otol Neurotol
Pays: United States
ID NLM: 100961504
Informations de publication
Date de publication:
18 Jan 2024
18 Jan 2024
Historique:
medline:
19
1
2024
pubmed:
19
1
2024
entrez:
19
1
2024
Statut:
aheadofprint
Résumé
To evaluate the efficacy of reduction meatoplasty, a novel technique aiming to improve the usage of molded hearing aids and ear plugs in patients undergoing mastoid obliteration of a previous canal wall-down (CWD) mastoidectomy, complicated with a very large meatus. Twenty-six patients from a tertiary care neurotology clinic with a very large meatus from a previous CWD mastoidectomy, who were unable to use molded hearing aids or ear plugs for water protection. Reduction meatoplasty after mastoid obliteration (cartilage strips and bone pate) of the CWD mastoidectomy. The procedure involves removing a wedge of skin and underlying soft tissue superiorly in the meatus. Reduction in meatus size, enabling usage of hearing aids and ear plugs. Twenty-six patients underwent mastoid obliteration and reduction meatoplasty to reduce meatus size. Patients were followed up for an average of 22 months postoperation. After operation, the meatus size was significantly reduced in all patients, enabling usage of over-the-counter ear plugs. In addition, all six patients with hearing aids could use standard occlusive hearing aid domes without requiring molded hearing aids. No patients showed symptoms of chronic infection in the mastoid cavity during the follow-up period. Results of reduction meatoplasty showed significant improvements in functionality of the external auditory meatus, indicating that this technique is effective in reducing meatus size and improving the normal meatal anatomy after mastoid obliteration.
Identifiants
pubmed: 38238906
doi: 10.1097/MAO.0000000000004110
pii: 00129492-990000000-00474
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024, Otology & Neurotology, Inc.
Déclaration de conflit d'intérêts
Conflicts of Interest: H.R.D. is an advisor and holds equity in NeuroMed Care LLC, Elinava Technologies, and Cactus Medical LLC. He is a consultant to NXT Biomedical.
Références
Khalil HS, Windle-Taylor PC. Canal wall down mastoidectomy: a long term commitment to the outpatients? BMC Ear Nose Throat Disord 2003;3:1.
Memari F, Maleki Delarestaghi M, Mir P, GolMohammadi M, Shams Koushki E. Meatoplasty in canal wall down surgery: our experience and literature review. Iran J Otorhinolaryngol 2017;29:11–7.
Harvey RJ, Fagan P, Baldwin M. Reduction meatoplasty with a post-auricular island flap. J Laryngol Otol 2007;121:158–9.
Shady EFA, El-Mofty IA, Hegazy EA, Abdelhakam RB, Abdelsamie AM. Comparison between classic 'Fisch' and 'corner-tag' meatoplasty techniques after canal wall down tympanomastoidectomy. Am J Otolaryngol 2023;45:104072.
Vadiya SI, Makwana P, Mehta N, Khetani S. Comparison of different techniques of meatoplasty after canal wall down mastoidectomy. Indian J Otolaryngol Head Neck Surg 2022;74(Suppl 1):589–92.
Varadarajan VV, Antonelli PJ. Efficacy of the mini-meatoplasty. Laryngoscope 2020;130:1294–8.
Nagaoka M, Noguchi Y, Kawashima Y, et al. Long-term result of meatoplasty using inferiorly based retroauricular island pedicle flap for external auditory canal stenosis. Auris Nasus Larynx 2016;43:382–6.
Hoffmann DF, Fagan PA, Taylor B. Reduction meatoplasty. Laryngoscope 1997;107:1127–8.
Azevedo AF, Soares AB, Garchet HQ, Sousa NJ. Tympanomastoidectomy: comparison between canal wall-down and canal wall-up techniques in surgery for chronic otitis media. Int Arch Otorhinolaryngol 2013;17:242–5.
Placanica T, Griffin A, Mahanta V, Jumeau P. Mastoidectomy indications and incidence in the indigenous population of Far North Queensland. Aust J Otolaryngol 2018;1:24.
Park KT, Song JJ, Moon SJ, et al. Choice of approach for revision surgery in cases with recurring chronic otitis media with cholesteatoma after the canal wall up procedure. Auris Nasus Larynx 2011;38:190–5.
Dodson EE, Hashisaki GT, Hobgood TC, Lambert PR. Intact canal wall mastoidectomy with tympanoplasty for cholesteatoma in children. Laryngoscope 1998;108:977–83.
Hulka GF, McElveen JT Jr. A randomized, blinded study of canal wall up versus canal wall down mastoidectomy determining the differences in viewing middle ear anatomy and pathology. Am J Otolaryngol 1998;19:574–8.
Kerckhoffs KG, Kommer MB, van Strien TH, et al. The disease recurrence rate after the canal wall up or canal wall down technique in adults. Laryngoscope 2016;126:980–7.
Hovis KL, Carlson ML, Sweeney AD, Haynes DS. The one-cut meatoplasty: novel surgical technique and outcomes. Am J Otolaryngol 2015;36:130–5.
Roy R, Gupta Y, Roy PK. A comparative analysis of canal wall reconstruction mastoidectomy over canal wall down mastoidectomy. Egypt J Otolaryngol 2022;38:107.