Eustachian tube function and size of the mastoid air cell system in middle ear surgery

Myringoplasty results in patients with poor tubal function and small cell systems are often disappointing, to both patient and surgeon. Surgical procedures to improve tubal function have been introduced but they all have the disadvantage of being rather elaborate and difficult to perform. The mastoid air cell system on the other hand does not offer the same problems of access. With the concept of creating an air-filled cavity in connection with the middle ear, mastoidectomy was performed in myringoplasty cases with poor tubal function and small (less than 9 cm2 lateral area) cell systems. Preliminary results show a healing rate of 82% in patients managed according to these principles, against 50% in corresponding cases when myringoplasty alone was done.