My experiences on meatoplasty and obliteration techniques in C.W.D mastoidectomy

My experiences on meatoplasty and obliteration techniques in C.W.D mastoidectomy
Alireza Karimi Yazdi
Otorhinolaryngology Research Center, Vali-e-asr Hospital, Tehran University of Medical
Sciences, Tehran, Iran

Canal-Wall-Down mastoidectomy (C.W.D) offers many benefits in properly selected patients. When we should do C.W.D mastoidectomy due to massive temporal bone pathology, osteomyelitis or distractive cholesteatoma it is necessary to use techniques for minimizing disadvantages of C.W.D procedure; Cosmetic and functional meatoplasty, Creation of a small size mastoid cavity, with the ability of self-cleaning.

For these goals we do as bellow:
1- Partial excision of conchal cartilage from posterior part of the auricle
2- Creation of a periosteal flap with T-shape incision
3- Incision of the posterosuperior skin of external canal terminated 4-5 mm far from root of helix. Incision are designed mediolaterally all along the canal
4- Creation of musculocutaneous flap adjacent to periosteal flap
5- Obliteration of mastoid cavity up to facial ridge
6- After obliteration we have small cavity instead of external canal lateral to the tympanic membrane graft.