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The article reflects the experience of examination and treatment of 146 patients with secretory otitis media, 52 patients with fibrous otitis media, 80 patients – with atelectatic otitis media and 22 patients with otitis media with tympanic cavity epidermisation. It has been established, that the main link in the pathogenesis of chronic otitis media with fibrosis and atelectasis of tympanic cavity is the scar “block” of the natural tympanic diaphragm fistules. The main reason of tympanic membrane mezotympanic retraction and tympanic cavity epidermization is the noncompensated expressed eustachian tube ventalatory dysfunction. The authors suggested the principles and methods of surgical treatment of patients with this pathology.

The article presents two cases of preoperative examination and surgical treatment of the temporal bone petrous pyramid cholesteatoma. Regardless the complexity of the temporal bone pyramid cholesteatoma, the choice of adequate surgical approach provides complete excision of cholesteatoma, minimizing the risk of postsurgical complications.

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The article describes the specific features of the pathogenesis of fibrous and atelectatic otitis media. The authors considered the problems of treatment of the patients with this pathology and determined the prospective directions in solving the problem of disease relapses.