Pathology as it relates to ear surgery. VII. Tympanoplasty.

The surgical anatomy and pathology of the middle ear have been reviewed in relation to tympanoplasty. The results of tympanoplasty in providing a disease-free and functional middle ear varies widely with the pathology involving the eardrum, ossicles, mucoperiosteum, mastoid air cells and eustachian tube. Post-tympanoplasty changes in the eardrum graft, ossicular grafts, and middle ear have been described in six cases which underwent surgery one to eleven years before death. Proper understanding of the pathophysiology of the different diseases of the middle ear is mandatory in planning tympanoplastic procedures. The causes of graft failure and of post-operative conductive hearing loss are discussed and the ways to avoid technical complications are emphasized.