Revision tympanoplasty including anterior perforations and lateralization of grafts.

Not long ago, the restoration of a perforated tympanic membrane by grafting over an air-containing tympanic cavity seemed impossible. Fortunately, successful results are so consistent and universal today that restoration of the tympanic membrane is expected, and a failure calls for careful evaluation as to "why". If known principles are observed, few complications need occur. Usually, complications are the result of either the choice and placement of the graft used in the repair, or the presence of unresolved upper respiratory pathology. When revision tympanoplasty is necessary, use of the underplay fascial graft technique, properly applied, usually can solve any difficult problems.