Tympanoplasty: an up-to-date pictorial review

The indications for tympanoplasty are mainly chronic ear pathologies, such as cholesteatoma, atelectasis and chronic tympanosclerotic otitis. Usually, modification of the mastoid and temporal tissues in general mostly involves bone work, which means bone removal by burs or appropriate bone curettes. It is for this reason that, in both the pre- and postoperative periods, the computed tomography (CT) scan is the primary radiological tool for studying the middle-ear, and temporal bone structures and pathologies. The aim of this review is to illustrate the most up-to-date postoperative results for tympanoplasty, including the emerging endoscopic techniques. The present work focuses on the five types of tympanoplasty that are likely to be encountered by the radiologist: radical surgery; open tympanoplasty; closed tympanoplasty; closed endoscopic tympanoplasty; and open endoscopic tympanoplasty. Understanding and interpreting temporal bone images in relation to the different types of surgery are important, especially at the postoperative stage, because of the high risk of recurrence of middle-ear pathologies, and a good working knowledge of surgical changes is fundamental for distinguishing iatrogenic bone demolition from complications and new pathological foci.