[Operative therapy for chronic otitis media and middle ear cholesteatoma with preservation of the posterior auditory canal wall ("intact wall technique") (author's transl)].

The late results of two different procedures for middle ear surgery are compared 2-10 years following surgery. A total of 478 ears were operated, of which 367 had cholesteatomas and 111 chronic granulating otitis without cholesteatoma. a) In conservative radical operations, tympanoplasties, meatoplasties with fascia and obliteration with muscle (298 ears) gave satisfactory and stable results: 8% required re-operation, 2.8% had residual cholesteatoma, 0.9% had recurrent cholesteatoma, 15% had perforations, and 90% had dry operative cavities. b) In modified "Intact Wall Technique" with small cortical mastoidectomies and epitympanic control openings, 7% had residual cholesteatomas, 2% recurrent cholesteatomas, and 11% required re-operation. The following conclusions were made: The "Intact Wall Technique" is a safe method for the surgical management of granulating otitis media. However, the procedure is not considered to be safe when disease involves cholesteatoma because of the significant frequency of recurrent disease or the development of retractions which can then form cholesteatoma. Under such circumstances, combination of the "Intact Wall Technique" with obliteration may give more stable results.