[Development from skin- to fascia- and to cartilage tympanoplasty (epitympanon-antrum-mastoidplasty) (author's transl)].

Experiences with 8029 endaural tympanoplastes show interruption of the self-cleaning process of the endaural epithelium after 366 tympanoplasties with skin grafts. The self-cleaning process may be preserved after fascia temporalis (2325) and cartilage (5338) plasties, because of overgrowth with local epithelium. 16 years after combined fascia temporalis and cartilage tympanoplasty the pieces of cartilage are almost unchanged but the fascia temporalis is more or less thinned to atrophic scars and according to tubal function it shows adhesive retraction pockets or bulging. For 7 years we have not been using fascia any more, but ear cartilage for the tympano-epitympano-antrum-mastoidplasty. Cartilage material not used is kept in a cartilage bank. Recurrence of cholesteatoma will press the cartilage plasty into the external auditory canal, whereas after osteoplasty of the endaural canal wall the patient runs to an uncertain percentage the same risk as before the operation.