In reviewing the history of the development of modern surgical procedures designed to manage chronic otitis media, one cannot help but be impressed by the fact that the surgeon has always been faced with two primary considerations: control of the disease and conservation of the patient's hearing. Pursuing the matter further, it becomes clear that these two surgical aims are often in direct conflict, for control of the disease usually involves extensive removal of tissue, which in turn leads to further loss of hearing. What was true in the pioneer days of mastoid surgery is still true today. It is therefore my wish to discuss the status of these two conflicting goals in the surgical treatment of chronic otitis media and to suggest a point of view which is in consonance with our present-day experience with this most difficult and challenging aspect of otologic surgery.
Since the end of the