Summary
Definitions: myringoplasty repairs a tympanic-membrane perforation without ossicular work; tympanoplasty reconstructs the drum and the sound-conducting mechanism, with ossiculoplasty when needed; tympanomastoidectomy adds mastoidectomy at the same operation. Name the operation by disease, approach and reconstruction.
Aims: control of disease and discharge, a stable ear, preserved or improved hearing. An asymptomatic perforation or a medically unfit patient may be managed conservatively. Cholesteatoma requires clearance of all squamous epithelium from the middle ear before drum closure; myringoplasty alone is inadequate.
Technique, timing and follow-up are tailored to the defect, the middle ear, the opposite ear, hearing needs, patient preference and surgeon experience.