[The concept of endaural tympanoplasty for severe congenital atresia auris (author's transl)].

The recommendation of a strictly endaural approach to the tympanic cavity in congenital atresia is based on a series of 26 cases of severe malformations (grade II and III). Two bony ridges at the lower edge of the atresial plate and the deep auricular artery served as landmarks. A bony posterior canal wall was always conserved or reconstructed. There was no collision with the facial nerve. The reobliteration of the new external auditory canal was avoided by four means: sufficient resection of both overlying soft tissue and the parotid gland, insertion of auto- or homologous cartilage into the anterior canal wall, Z-plasty of the buccal skin, and delayed implantation of split skin. The average gain of air conduction was 19 dB IN 14 controlled ears.