Tympanomastoidectomy. A 25-year experience

Since 1956, 1,540 tympanomastoidectomy procedures for cholesteatoma or chronic suppurative otitis media with mastoiditis have been performed; 180, done from 1972 through 1980, were reviewed in detail for effectiveness of surgery, control of disease, and hearing results. The majority of the procedures were done for cholesteatoma. Almost all of these had preoperative sclerotic or poorly developed mastoids as judged by x-ray examination. A limited open-cavity technique with one-stage tympanic repair has resulted in long-term control of cholesteatoma in the mastoid segment in almost every case and reasonable success in control of middle ear disease and preservation or improvement in hearing. Properly performed modified radical mastoid cavities seldom cause problems in postoperative care, do not preclude swimming, and do not impair concomitant tympanoplastic repair. Failure to control disease in the middle ear or to improve hearing is the major problem. Revision tympanoplasty can correct some of these remaining problems, but is usually an elective procedure.