Some Problems of Tympanoplasty

THIS paper is based on the experience I have gained over the last two years from the performance of 142 plastic operations on the middle ear in patients suffering from chronic suppurative otitis media. I believe these new techniques are a remarkable advance in the surgical treatment of a common and disabling disease and replace in most cases the existing methods of surgical treatment which in any case have never been wholly satisfactory for the patient or the surgeon; the modified radical operation is often inadequate and does not always remove the disease in the middle ear and the classical radical operation is a destructive operation which is today rarely justifiable. I wish to discuss the problems I have encountered under four main headings: