[Improvement of hearing function through ear reoperation. The role of tympanic revision for functional indications]

Recurrent middle ear disease may carry a high probability of complications, and there is no doubt of the necessity of revision surgery for either cholesteatoma or tumor. However, failures in function should be individually analyzed before a second procedure is decided upon. A pre-requisite for surgical improvement of hearing is adequate tubal and inner ear function. Chronic suppurative otitis media has a higher tendency for reperforation than cholesteatoma. Adhesive otitis indicates poor tubal function. Tympanosclerosis may cause refixation requiring stapedectomy at a second stage. Middle ear fibrosis recurs in about 50% of cases. Post-operative failures such as extrusion of ossicles, lateralization of the tympanic membrane, and blunting of the anterior tympanomeatal angle as well as failures after stapes surgery are discussed.