THE well-known methods of treatment (tympanoplasty and artificial middle ear) in cases of damage to the eardrum and the ossicular chain are attempts to restore the normal system of sound transmission.
Tympanoplasties have a number of limitations: (1) A normal patency of the eustachian tube is required. (2) Postoperative management can be lengthy and difficult. (3) A framework to support the tympanoplastic flap is often absent and the new middle ear cavity may be gradually obliterated, leading to a deterioration of hearing.
Various modifications of the artificial middle ear are ingenious in construction, but their prolonged use is not always convenient for the patient.
The chief aim of hearing improvement methods now being used is to concentrate sound towards the oval window and to reconstruct a normally functioning middle ear to the greatest extent. Theoretically the sound improving effect depends less on the absolute sound pressure upon the oval window
Gaudin EP. Hearing Improvement by Sound Isolation of the Round Window. Arch Otolaryngol. 1968;87(4):376–377. doi:10.1001/archotol.1968.00760060378007
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