As far as I know, ETTL doesn't rely on the sensor on the flash. TTL stands for Through-The-Lens, after all.
If you're in control of the lighting, and you have time to make adjustments, then use manual mode for both the camera and the flash power. ETTL will adjust flash power based on the contents of the image, and for most studio-style setups you DON'T want this to happen.
For example: You have a model with pale skin and long, full, black hair. You get everything set up so that it's properly exposed when her hair is in a ponytail behind her head. But, then when she lets her hair down and it sweeps around to the sides and front of her face, the camera and ETTL will think "wow, look at all that dark stuff in the image, better boost flash power a little bit."
I've never needed a light meter; I instead use a gray card/exposure target, the blinkies and the histogram. Many people swear by light meters, but after a bit of experience with my gear and tools, I can get my desired exposure with only one or two test shots.
If you're experienced with your light meter, then by all means use it. Just remember that if your subject is far away from the background, the single main-light flash will affect the subject but not the background, or it'll affect the background to a much lesser extent than the subject. Expose with camera settings for the background, expose the subject with the flash.