Surgical approach to hearing improvement in the radically operated ear.

Our method of improving hearing in patients with old radical cavity is presented. Tympanoplasty is generally indicated for cases of persistent aural discharge with no severe tubal dysfunction. A preserved homologous septal cartilage plate was used to reconstruct the aerated tympanic cavity and to hold the columella material. For cases with insufficient opening of the eustachian tube, planned staged operations were performed following reopening of the tube and insertion of the protuberance part of a silicone plate. Functional results were satisfactory in 12 cases followed up for longer than 2 years (success rate in 80% of the modified type III and in 57% of modified type IV procedure).