Seventy-four ears received type III or modified type III and thirty seven ears received type IV or modified type IV tympanoplasty between December 1983 and March 1993 were followed for more than one year.
Postoperative complications were as follows; 1) exposure or extrusion of the columella occurred in 6 (24.0%) of 25 ears using plastipore PORP and in 7 (38.9%) of 18 ears using plastipore TORP, 2) attic retraction pockets were found in 36 (57.1%) of 63 ears with cholesteatoma and in 14 (29.2%) of 48 ears with non-cholesteatoma, and 3) residual cholesteatoma was found in 1 (1.6%) of 63 ears with cholesteatoma, and retraction cholesteatomas were found in 5 (7.9%) of 63 ears with cholesteatoma and in 2 (4.1%) of 48 ears with non-cholesteatoma.
Compared with postoperative hearing results after one year, the hearing after more than three years was deteriorated in type III tympanoplasty. It was suggested that the cause was impairment in mobility of the ossicles or columella by advance of the attic retraction or re-adhesion of the ear drum.
Since attic retraction pocket or retraction cholesteatoma occurred even in postoperative ears with non-cholesteatoma, it was expected that mastoid obliteration is a better procedure in order to prevent postoperative attic retraction not only for cholesteatoma but also for non-cholesteatoma which has severe lesion around the tympanic isthmus.
