[Tympanoplasty and mastoidectomy in patients with large perforation of tympanic membrane in pars tensa].

OBJECTIVE: To present the experiences of tympanoplasty in patients with large perforation of tympanic membrane in pars tensa.

METHOD: Of 147 patients who underwent surgery for chronic otitis media with large perforation of tympanic membrane in pars tensa,101 patients without mastoid problem underwent tympanoplasty, 46 patients who had evidence of middle ear, antral/epitympanic, or mastoid disease underwent tympanoplasty with mastoidectomy.

RESULT: The tympanic membrane graft take rate for the entire group of 147 patients was 96.6% (142 grafts succeed). The average postoperative pure tone air-bone gap was (16.6 +/- 10.9) dBHL after 3 months of the operation.

CONCLUSION: To patients with chronic supperative otitis media and large perforation of tympanic membrane, the CT scan before operation and detailed exploration of tympanum are necessary. The drainage of Eustachian tube, attic and antrum must be enough. The cartilage-perichondrium composite is an ideal material for reconstruction of the drum, the attic and the posterior tympanum.