THE CHIEF aim of contemporary otosurgery, the reconstruction of the conducting system of the middle ear, may be attained by various kinds of tympanoplastic operation. In otosurgical practice cases may often be encountered in which "tympanoplasty" has occurred spontaneously, by natural forces, in the course of chronic otitis media, or by the cicatrization of the morbid changes in the middle ear during healing. Pictures of "spontaneous tympanoplasty" occur most frequently in incipient perforations of the pars flaccida of the tympanic membrane and inflammation of the tympanum superior, and so there exist natural conditions for the demarcation of the medial and inferior tympanum from the superior, eg, by a cholesteatomatous sac developing towards the entrance to the mastoid cavity. Apparently when primary cholesteatomas occur in the tympanum superior there exist particularly favorable conditions for the pars flaccida to form a natural covering separating the chain of auditory ossicles from the posterosuperior
WLODYKA J. Spontaneous Tympanoplasty. Arch Otolaryngol. 1965;82(5):506–509. doi:10.1001/archotol.1965.00760010508010
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