Optimal meatoplasty in canal wall down tympanomastoidectomy: a SMAART 2 flap technique
Bibliographic record
Abstract
OBJECTIVES: To identify 'on-table optimal meatal opening size' that predicts post-operative mastoid cavity healing in the canal wall down tympanomastoidectomy. To develop a specific, measurable, achievable, acceptable, replicable and time-bound (SMAART) meatoplasty. METHOD: A double-blind randomised control trial where patients were randomly assigned to standard Portmann 3 flap and new SMAART 2 flap technique. RESULTS: There were 18 and 17 participants in the former and latter, respectively. Dry ear was achieved when the on-table ratio of tympanomastoid cavity volume to meatal opening size was 2:1. In a mastoid cavity of 6 ml or less, among the 2 flap patients, the majority had epithelialisation completed by the first month, meatoplasty having significantly shorter duration (12.2 versus 32.3 minutes) and cosmetically better than 3 flap. CONCLUSION: Optimal meatoplasty is when tympanomastoid cavity volume ratio to meatal opening size is 2:1. When the on-table mastoid cavity is either 6 ml and less or is obliterated to 6 ml and less, the new SMAART 2 flap meatoplasty should be considered.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".