The one-cut meatoplasty: novel surgical technique and outcomes ☆ Kristen L. Hovis, BA, Matthew L. Carlson, MD, Alex D. Sweeney, MD, David S. Haynes, MD ⁎ Department of Otolaryngology, Head and Neck Surgery, Vanderbilt University, Nashville, TN ARTICLE INFO ABSTRACT Article history: Received 12 August 2014 Purpose: To present the surgical technique and clinical outcomes of a novel modification to conventional meatoplasty. Materials and methods: All consecutive patients undergoing canal wall down tympanomastoidectomy incorporating the one-cut meatoplasty technique between January 2009 and February 2013 were evaluated. Primary outcome measures included meatal stenosis requiring revision surgery, frequency of drainage beyond 2 months postoperatively and results of a composite patient questionnaire incorporating the Chronic Ear Survey. Results: Twenty-eight of 36 (78%) eligible patients completed a questionnaire and were included. All ears underwent canal wall down tympanomastoidectomy utilizing the one-cut meatoplasty technique. At a mean follow-up of 38.0 months, the average Chronic Ear Survey score was 78.6 ± 2.6 points. There was only one case of postoperative meatal stenosis. Intermittent otorrhea developed in 14.3% of cases but was remedied by conservative measures including in-office cleaning, ototopical therapy and water precautions. Eighty-nine percent of patients denied any self-consciousness about the aesthetic appearance of the ear. Conclusions: The one-cut meatoplasty is an effective alternative to traditional techniques that is simple to perform. The results of the Chronic Ear Survey indicate that the one-cut meatoplasty supports a stable and healthy, open cavity with functional results that compare favorably to other series evaluating canal wall down tympanomastoidectomy with traditional meatoplasty. Additionally, patients report high satisfaction with the appearance of their ear, and all hearing aid users could continue to utilize a hearing aid without feedback, pain, or other difficulties related to poor fitting. © 2015 Published by Elsevier Inc. 1. Introduction The primary objective in the surgical management of chronic otitis media is to create a dry and safe ear. Tympanomastoidectomy techniques in this setting can be distinguished by their treatment of the external auditory canal. The canal wall down (CWD) tympanomastoidectomy involves removal of the posterior bony canal in order to improve surgical exposure and to exteriorize AMERICAN JOURNAL OF OTOLARYNGOLOGY – HEAD AND NECK MEDICINE AND SURGERY 36 (2015) 130 – 135 ☆ Financial Material & Support: No funding or other support was required for this study. ⁎ Corresponding author at: Department of Otolaryngology-Head and Neck Surgery, The Bill Wilkerson Center for Otolaryngology & Communication Sciences, 7209 Medical Center East, South Tower 1215 21st Avenue South, Nashville, Tennessee 37232-8605. Tel.: + 1 615 322 6180; fax: +1 615 343 7604. E-mail address: david.haynes@vanderbilt.edu (D.S. Haynes). http://dx.doi.org/10.1016/j.amjoto.2014.10.002 0196-0709/© 2015 Published by Elsevier Inc. Available online at www.sciencedirect.com ScienceDirect www.elsevier.com/locate/amjoto