Abstract

DURING the past decade tympanoplasty has tremendously improved the lot of patients with chronic middle ear disease. As a result of this surgery many patients have a high incidence of dry ears with permanently closed perforations as well as permanent hearing improvement instead of further hearing losses as a result of the former policy of watchful waiting or inadequate surgery. Pathology According to Sade 1,2 serous otitis media is not a sequel to vacuum in the middle ear but an exudate from the mucosa secondary to infection. Persistence of effusion may be due to ciliary deficiency, ciliary inability to cope with tenacious mucus or to hypersecretion, all of these being middle ear clearance problems. Some politzerizable eustachian tubes are incapable of equalizing nasopharyngeal and middle ear pressures when there is a chronic negative pressure in the middle ear. This results in retracted atelectatic eardrums. Buckingham 3 reexpands these cases

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