Abstract
In this review the indications for surgery are discussed, based on the literature and own publications. In 185 ears of children up to 14 years, 9.1% recurrent perforations were found. Otitis of the ossicles is rarer than in adults and in cholesteatoma in children. Tubal function seems to influence the results. These factors are discussed. Surgery is indicated to improve and to prevent ossicular destruction; furthermore, the children are able to participate in swimming and sports without ear protection. Delay of tympanoplasty is recommended if bad cooperation makes pre- and postoperative treatment difficult, and in cases where a secretory otitis media on the contralateral ear indicates poor tubal function. A persisting perforation after extrusion of a grommet should not be closed immediately.
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