A Novel Technique of Reduction Meatoplasty for Correction of Very Large Meatus from a Previous Canal Wall-Down Mastoidectomy.

Objective: 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.
Patients: 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.
Intervention: 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.
Main Outcome Measures: Reduction in meatus size, enabling usage of hearing aids and ear plugs.
Results: 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.
Conclusions: 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.
Competing Interests: 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.
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