[The last ear (author's transl)].

An operation of the last ear should not be rejected completely, neither from the clinical nor from the audiological point of view. The special pathology of the ear should be considered critically. Many factors can influence the success of the surgical intervention. An exact and adequate diagnosis taking into consideration all the risk factors has to precede each intervention on the last ear. The personality of the patient and his psychological structure have an important influence on the final decision. The surgeon must be very thorough and careful in explaining the possible consequences of an operation. The intervention should be carried out by an experienced surgeon using a tried and proven method. In the case of operations that are neither threatening the life of the patient nor absolutely necessary from the medical point of view he should stop the intervention when--during the operation--the risk for the remaining hearing capacity results to be too high. In this situation the ear should be dried up and prepared for an hearing-aid. We should ever keep in mind that the hearing-aid even if the communication is not fully-satisfying--is better than an understanding by only lip-reading. The medical principle "nil nocere" is particularly important for the last ear.