[Revision after surgical procedures in the middle ear and mastoid]

In a group of 46 revised operations the most frequent cause of revision was persisting secretion--in 41 patients. After elimination of general causes and after failure of conservative treatment, during revision the following local causes were revealed: relapse of cholesteatoma in 44%, inflammation of the residual or repneumatized spaces in 41%, ostitis of the long process of the incus in 10% and inflammation in the divided trepanation cavities in 5%. By the first revision the authors achieved a dry trepanation cavity in 58.5% of the operated patients. By the second and third revision they increased the number of dry trepanation cavities to 83% and in the remaining ones there was only an occasional secretion. The revision involved usually a more radical procedure. In some of the patients operated by the "closed" technique the authors changed to the "open" technique. A radical approach to the auditory ossicles and the ear drum, if they were preserved during the primary operation, led to a deterioration of hearing in 22 of 41 operated patients, i. e. in 53.66%. This is the cost of obtaining a dry trepanation cavity.