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March 1960


Author Affiliations

Houston, Texas

AMA Arch Otolaryngol. 1960;71(3):369-375. doi:10.1001/archotol.1960.03770030011003

Myringoplasty, which could better be called "Wullstein Type I Tympanoplasty," is used where a perforation of the tympanic membrane is the only defect in the ear structures. Most authorities consider it the most successful of the various tympanoplasties.

Unfortunately, there is growing evidence that myringoplasty is frequently mishandled. This may be owing to faulty technique, but it is usually because an inadequate preoperative work-up failed to recognize certain complicating situations. If there is one thing I would like to get across, it is that you should not close every perforation that you see in your patients. For instance, when a non functioning Eustachian tube is present, myringoplasty will produce a very annoying secretory otitis media, and the patient will be much more miserable than he was with his perforation. Or, there is a possibility of burying squamous epithelium underneath the graft by mistakenly skin grafting over the mouth of a