Tympanoplastic procedures have now been practiced for more than 10 years, and most of the surgical methods are already well standardized. Excellent descriptions of different alternatives are given in textbooks on ear surgery by Shambaugh1 and by Portmann, Portmann, and Claverie.2 In evaluating the results, the Wullstein classification into 5 different types is generally used.
The experience in our clinic with these procedures has been reported for 2 periods, 1950-1952 (Palva and siirala, 1954.3) and 1953-1958 (Palva and Pulkkinen, 19604-5). During the first period, myringoplasty and columellization were the standard procedures. The cavum minor technique with a full thickness graft (fourth type) was not yet being attempted. If the Thiersch graft did not result in a viable membrane, a prosthetic covering of the round window was utilized. During the latter period, in the absence of the stapes, "sound shadowing" of the round window with full thickness
PALVA T. Reconstruction of Ear Canal in Surgery for Chronic Ear. Arch Otolaryngol. 1962;75(4):329–334. doi:10.1001/archotol.1962.00740040338005
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