Meatoplasty for Lateral Stenosis of the External Auditory Canal

INTRODUCTION Creation of a large meatus is an essential step in a canal wall down mastoidectomy to achieve a dry cavity. The surgical technique for such a meatoplasty has been described previously by the senior author (U.F.). It is equally important to ensure that there is an adequate external auditory meatus in situations in which the canal remains intact. Lateral stenosis of the external auditory meatus is most commonly related to either a congenital malformation of the canal or recurrent otitis externa (Fig. 1). It may also be iatrogenic, following otologic surgery or irradiation. Stenosis of the meatus has the potential to cause a number of problems. These include accumulation of cerumen, chronic otitis externa, hearing impairment, and difficulty in examining the ear. At the University of Zürich, all these problems have been indications for surgical intervention. Meatoplasty of the external auditory canal is also an essential step in conjunction with other otologic procedures. In the context of procedures such as tympanoplasty, bony canaloplasty, and removal of exostoses, the correction of lateral stenosis of the external auditory canal provides improved visualization both at the time of surgery and in the postoperative period. A meatoplasty in these situations has been well recognized as a mandatory step. Numerous surgical techniques to correct lateral stenosis of the ear canal have previously been described. The disadvantage of these techniques is that they are either excessively complex or fail to recognize the need to remove both excess cartilage and bone to achieve a proper meatoplasty. The ideal meatoplasty for lateral stenosis of the external auditory meatus should be simple to perform,