Surgical management of tubo-tympanitis

An intact canal wall mastoidectomy with facial recess opening was performed on 41 patients (47 ears) with non-cholesteatomatous chronic otitis media from January 1986 to July 1992. Full information was available in 32 ears (28 patients). All the patients had a minimum of 12 months continuous mucopurulent otorrhoea despite intensive medical therapy. Twenty-five of the patients had undergone previous, unsuccessful, surgical attempts in order to resolve their middle ear infections. Follow-up ranged from one to five years and the results of surgery, with emphasis on eradication of infection and repair of the tympanic membrane defect, were assessed. Successful treatment of otorrhoea and closure of the perforation was achieved in 30 ears. It is concluded that the essentials of surgery for non-cholesteatomatous chronic otitis media are exenteration of all mastoid cells and a wide facial recess opening in order to ensure aeration of the mastoid cavity.