Since Wullstein and Zöllner published their fundamental papers upon tympanoplasty the interest taken in this field of otological surgery has been overwhelming. Most surgeons have tried these operations, in some cases successfully but probably in more cases with less satisfactory or even bad results. One of the reasons for this is that skin, especially full-thickness grafts from the retroauricular area, has been used to repair the middle ear. Guilford, among others, has pointed out the risk of perforation, dermatitis, and the formation of a cholesteatoma which this method entails.
To solve these problems many different materials have been used as a graft, such as mucous membrane taken from the cornea, pericardium, peritoneum, fat, fascia, or periosteum.
Very suitable for this purpose is the skin from the inner part of the posterior osseous wall of the external acoustic meatus, because histologically it is very similar to the drum, as pointed out
ELBROND O. Myringoplasty According to Shea's Method. Arch Otolaryngol. 1964;80(4):402–406. doi:10.1001/archotol.1964.00750040414008
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