A 35-year-old man undergoes canal wall down mastoidectomy for cholesteatoma. Post-operatively, he develops a cavity that requires regular cleaning every 3 months. Which surgical modification at the time of primary surgery most effectively reduces the cavity maintenance burden?

• A Wide meatoplasty to create a self-cleaning cavity
• B Canalplasty to enlarge the external auditory canal
• C Insertion of ventilation tube in the tympanic membrane
• D Obliteration of the mastoid cavity with abdominal fat ✓

Explanation

Obliteration of the mastoid cavity with abdominal fat (or temporalis muscle flap) fills the dead space created by canal wall down surgery, converting a large cavity to a smaller one that is easier to maintain and self-cleaning. Wide meatoplasty helps but is not as effective as obliteration for reducing cavity size. Canalplasty and ventilation tubes address different problems.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.