SURGERY of the "chronic ear" has aroused considerable interest during the last few years, and many new techniques have been developed to obtain a more permanent and satisfactory end result by operative intervention. During the past decades, up to 1960, the general trend was to make an open mastoid cavity, possibly covered with Thiersch's grafts, full-thickness grafts, or left uncovered. Bacterial examination of the discharge was not considered absolutely essential since, even if the postoperative cavity became infected and remained so, there was a free outlet for discharge into the external meatus and out of the ear.
During the last five years the attitude of ear surgeons has changed essentially owing to their discontent with open mastoid cavities. In most clinics particularly interested in ear surgery, the operation is now completed with reconstruction of the drum and meatus, and the mastoid cavity is excluded from meatal connection by various means.
PALVA T, HALLSTROM O. Bacteriology of Chronic Otitis Media: Results of Analyses From the Ear Canal and From the Operative Cavity. Arch Otolaryngol. 1965;82(4):359–364. doi:10.1001/archotol.1965.00760010361005
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