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Technique
2 Tympanoplasty: Indications and Technique
Fig. 2.2 (A) Chronic suppurative otitis media. (B) Previous ear, treated with oral and topical
antibiotics.
Perforated Eardrum with Chronic Suppurative
Otitis Media
With chronic suppurative otitis media (CSOM) one tries to dry the
drainage if possible with general medical procedures such as topical
and oral antibiotics, improvement of eustachian tube dysfunction, or
allergy management. In some patients the drainage may not be
controlled prior to surgery. The principles outlined earlier are followed,
with the possible addition of an aerating mastoidectomy in a select
patient group (Fig. 2.2A,B).
Perforated Eardrum Secondary to Cholesteatoma
One must determine whether the perforation caused by the
cholesteatoma is confined to the middle ear or extends into the
epitympanic space or mastoid (Fig. 2.3).