Assessment of Results of Conchomeatoplasty Using Subjective and Objective Parameters in Canal Wall Down Mastoidectomy

Conchomeatoplasty is an important step of canal wall down mastoidectomy performed to promote dry, self-cleaning ear. Various techniques of conchomeatoplasty have been described and each has documented good results. However, a consistent and reliable method of assessing the outcome has not been explored. This study focuses on assessing the results of radial incision technique of conchomeatoplasty advocated by us using both subjective and objective parameters.

A prospective observational study was designed to assess 55 patients of canal wall down mastoidectomy with conchomeatoplasty. These patients were evaluated for the ear canal size at 3 and 6 months post operatively. A modified chronic ear survey questionnaire where patients' activity restriction, symptoms and medical resource utilization subscale were noted for subjective outcome. Objective evaluation analysed otoscopic visibility of superior limit, floor of mastoid bowl and sino-dural angle.

The mean size of external auditory meatus at 3 and 6 months were 9.861 mm and 10.145 mm respectively. At 6 months follow up, there was a significant association between visibility of landmarks and size of external auditory canal as well as with the necessity of water restriction. However, there was no association of size of ear canal with interference with social activity, frequency or quantity of ear discharge and frequency of physician's visit.

Using subjective and objective parameters facilitates a consistent and measurable assessment of the outcome of conchomeatoplasty rather than considering the size of meatoplasty alone. The radial incision technique advocated in the present study gives good postoperative results.