Reconstructive middle-ear surgery for chronic otitis media.

Chronic otitis media can be divided into the non-cholesteatomatous ears and the cholesteatomatous ears. The non-cholesteatomatous ears are most suitable for reconstructive middle ear surgery and the majority of the patients can expect a dry trouble-free ear with good hearing after the operation. Surgery for the cholesteatomatous ear is not only difficult but must be exact as residual disease can lead to fatal intra-cranial complications. Unlike the non-cholesteatomatous ears, not all cholesteatomatous ears are suitable for tympanic reconstruction. In both types of ears, eradication of disease takes priority and precedes tympanic reconstruction. Basically, tympanic reconstruction consists of repair of the tympanic membrane defect or myringoplasty and repair of the ossicular defect or ossiculoplasty. A scheme or surgical management for chronic otitis media is outlined. Between May 1977 and October 1979, 165 cases were seen by the author in the ENT Department, Singapore General Hospital and operated in accordance with this scheme of management and the results are analysed.