抄録
Tympanoplasty, on the bases constructed by the pioneers, has made a great improvement for these ten years. To this day the purposes of this operation have been considered to lie in the cure of chronic inflammation and the improvement of hearing. Recently the problem of the treatment of postoperative mastoid cavity rose to the surface. Strictly this is not concerning tympanoplasty in itself, but postoperative secretion from the mastoid cavity provokes disturbance of epidermisation not only in the mastoid cavity but also in the newly-formed ear-drum.
The fundamental solution of this problem is to build an external meatus in a natural way. In this sense, the obliteration method of a mastoid cavity has been prevailing.
In 1960, the author reported the so-called meatoplastic method preserving the posterior wall of the meatus and the lateral wall of the aditus.
When the operation is performed on the tympanic mucous membrane with pathological change, it is very important to know that complete cleaning does not run parallel with the recovery of function. In order to prevent postoperative adhesion, as much tympanic mucosa ought to be preserved as possible, except the parts suffering from pathological change.
In these series the meatoplastic method (the empty-cavity method) was performed in 84 cases of chronic otitis media. The results were as follows:
1) The vast majority of mucous membrane with pathological change was seen especially around the stapes. Much attention was paid to preserve the ossicular chains.
2) 19 cases failed and needed reoperation. The operation itself was not wrong, but the tympa-noplasty needed too much skillfulness to be successful.
3) Concerning the hearing, good result was obtained in 49 cases. 27 out of these cases had had hearing disturbance preoperatively more than 30 db.
4) Better results were obtained in the cases dealt with the meatal skin than with the free graft.
The author concluded that the meatoplastic method was an attempt to construct a dry exter-nal canal, and many efforts should be made in the future to approach the preservation of the normal anatomical contour of the auditory organ.
