Meatoplasty is an important part of a CWD procedure and is performed as follows: an assistant grasps the ear and pulls it laterally. Using a new No. 69
blade, I transect the posterior skin and then remove as much subcutaneous fat from the flap and all of the conchal cartilage that is available. I then pedicle this inferiorly and, with a 4-0 chromic suture, sew it to the adjacent muscle. This now allows a pedicled flap to be everted and allows a layer of skin to start the epithelialization process of the mastoid bowl. It should be made quite large to assure aeration, self-cleaning, and the ability to inspect and clean in the office.
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