[Our current criteria in tympanoplasty surgery]

The choice of surgical techniques has gone through a great evolution during the last few years in our service. Closed techniques were formally used in 80 per 100 of our operations (1974-1979) and now this has dropped to 12.5 per 100 (1979-1983) motivated by the failures we obtained with the closed techniques. This is similar to the observations of other services. We have determined the causes of failure to be related to: difficulties in dominating the surgical field, treatment of the cavity, or reconstruction of the walls. We present the antro-exclusion attic elimination on demand (A.A.D) technique which is designed to resolve not only the elimination of the lesion, but also the cavity problem. We have also evaluated the possibility of reconstructing the mastoid and pneumatic cavities connected to the tympanic case.