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David E. Tunkel, MD

Arch Otolaryngol Head Neck Surg. 2006;132:1319-1322.

Objective  To determine the effectiveness of the Z-meatoplasty technique for enlargement of the external auditory meatus of children undergoing modified radical mastoidectomy.

Design  Case series.

Setting  Pediatric otolaryngology practice in an academic setting.

Patients  Consecutive sample of children (18 years old) who had undergone modified radical mastoidectomy performed by the author from 1995 to 2005.

Intervention  Z-meatoplasty technique used as part of modified radical mastoidectomy.

Main Outcome Measure  Development of postoperative stenosis of the external auditory meatus that required additional surgery.

Results  A total of 28 children and 29 ears were treated with modified radical mastoidectomy during the study period. The Z-meatoplasty was used in 24 ears, and 3 (12.5%) required revision meatoplasty for meatal stenosis. Twenty-one ears (87.5%) treated with Z-meatoplasty had excellent healing and cosmesis without stenosis, during a mean follow-up period of 40 months.

Conclusion  The Z-meatoplasty is an effective technique for use during modified radical mastoidectomy to treat children with cholesteatoma.

Author Affiliation: Departments of Otolaryngology–Head and Neck Surgery and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md.