Tympanoplasty on only hearing ears

The methods, results, and indications for operation on only hearing ears are discussed on the basis of 13 patients operated upon for chronic otitis media and its sequelae. Although good results were obtained, with an air-bone gas closure within 15 dB. in 77 per cent, this should not serve as propaganda for the general use of surgery on only hearing ears. On the other hand, they show that surgery on only hearing ears should not be rejected a priori and that on certain indications and under c ertain circumstanc es it may be carried out with minimal risk of aggravating the hearing loss. In most of the patients the indication for surgery was a progressing cholesteatoma, in some cases the sequelae of otitis, either in the form of myringoplasty or type II tympanoplasty, and one patient had the operation on a vital indication. To avoid postoperative exacerbation of the hearing, the patients must be strictly selected, the ears have to be pretreated conservatively, the Eustachian tube must be passable, the operation must be carried out by the most experienced otosurgeon, and thoroughly tested, very gentle operative methods must be used.