[Meatoplasty using island pedicle flap]

Meatoplasty is designed to create a lasting external auditory canal and provide improvement in hearing acuity. In three patients with congenital atresia of the external auditory canal not requiring otoplasty, we carried out meatoplasty using an island pedicle flap obtained from the postauricular region. The island pedicle flap was made into a tubed pedicle when sutured with the epidermis facing inward, which was then made into a blind tube pedicle flap when sutured to a free skin graft. The external auditory canal was completed when the blind tubed pedicle flap was inserted into a newly created external auditory canal. Since the operation, two of the three patients have benefited from remarkable improvement in hearing acuity, and all three patients have been free of atresia in the newly created auditory canal. This procedure has the following major advantages: the island pedicle flap is nourished by the posterior auricular artery; the procedure provides an island flap wide enough to cover the newly created auditory canal; and the operation can be performed in a one-stage procedure.