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.
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