抄録
During the last ten years, 600 tympanoplasties were achieved in our clinic, and in this report the results of 253 tympanoplasties in simple otitis media were analyzed and discussed. The case was decided to be successful when the postoperative hearing loss or the air bone gap was smaller than 30 dB with no discharge. The summary is as follows:
1. Sex and age are not responsible to the healing.
2. Results in type I, II and III tympanoplasties, the healing ratios are all over 75%, but that in type IV tympanoplasty is only 33%.
3. When the hearing loss is greater than 45 dB before the operation, the healing is not sufficient.
4. The size of the drum perforation is not responsible to the healing ratio.
5. Dry ear is desirable for good result, but the amount of the discharge is not responsible to the healing.
6. The mucous membrane of the promontrium seemes to be conservable in the most cases, but the polypous or granulated membrane must be stripped and a mass of gelfoam should be packed in the tympanic cavity.
7. Combination of mastoidotomy and atticotomy with tympanoplasty is important to gain a good result, Especially atticotomy is absolutely necessary to gain the correct finding on the osssicular function.
8. The material of the tympanic graft is the best with fascia or vein.
9. For the reconstruction of the ossicular chain in type III tympanoplasty, the interposition of the graft between the stapes and the malleus shows the best result. Therefore the malleus should be conserved.
10. The tubal function must be good.
11. The mixed deafness is not a disadvantage for the tympanoplasty.
12. Because of the high healing ratio, the result between the surgeons is highly different.
