Tympanic reconstruction. Fifteen year report on tympanoplasty. Part II.

This survey was carried out to evaluate techniques in current use for the treatment of chronic suppurative otitis media. Part I concerns the incidence of cholesteatomatous complications following combined approach tympanoplasty (CAT). Residual and Recurrent cholesteatoma occurred much more frequently than had been expected or reported elsewhere. Although the incidence of Recurrent cholesteatoma has been markedly reduced by technical modifications, Residual cholesteatoma was discovered inadvertently in one out of every seven previously cholesteatomatous ears in which a second operation for ossicular reconstruction was performed. In at least one-third the disease had been left in the epitympanum. Although many cholesteatomatous cysts might lie dormant for years, and possibly never give rise to serious consequences, it can no longer be claimed that CAT provides a satisfactory means of eradicating cholesteatoma unless re-exploration operations were continued until eventually the tubotympanic cleft could be shown free of cholesteatoma.