Posterior meatal wall reconstruction in tympanoplasty.

An operative method is described which has been employed in 41 cases of severe chronic otitis media. The posterior meatal wall was removed and reconstructed during the same operation, following cleansing of the middle-ear cavity and ossiculoplasty. Either autograft bone (previously removed from the meatal wall) or homograft cartilage was employed for the reconstruction. All the ears were found to be dry at the follow-up examination after an average of 28 months, but 18 per cent had recurrence of the cholesteatoma. A SRT improvement of 5-30 db, was observed in 78 per cent, and in 21 per cent a deterioration of between 0 and 10 db. The method provides a good field of vision of the middle-ear cavity and in no cases was rejection of the re-implanted material observed.