Reconstruction of the Eustachian tube and the anterior tympanum: planned staged tubo-tympanoplasty.

A new technique is demonstrated in the management of chronic otitis media with inflammatory stenosis of the Eustachian tube. Bone exposure of the Eustachian tubal orifice and peritubal air cells was followed by placement of a long T-shaped solid silicone plate in this area. Postoperative care was taken to ensure wound healing in the same way as after radical mastoidectomy. At the second stage surgery the Eustachian tube and pretympanum were found to have developed with an intact mucous membrane. A middle ear space with or without reconstruction of the posterior meatal wall and obliteration of mastoidectomy cavity could easily be rebuilt. A sound pressure transformer mechanism could be established at the second stage surgery.