In all radical mastoidectomies the aim of the otologists has been. not only not to disturb the hearing ability but, if possible, even toimprove it. In order to achieve this goal damage to the inner ear through infection had to be prevented, and on the other hand, great care had to be taken to keep the sound conducting structures of the middle ear, if possible, intact.We all know from our own experiences and from large statistics, that in the treatment of otitis media this aim had met with very limited success. Only in certain operations, for instance, in very small cholesteatomas in Prussack's space was it possible to preserve good hearing or even to improve it. A systematic restoration of the function of the diseased ear has, however, been absolutely impossible.The development of microsurgery, since Gunnar Holmgren, and the modern control of infections through antibiotics and sulfonamides, has opened completely new possibilities in otology. The increasing success of the operative treatment of otosclerosis, to which American authors have made such splendid contributions, led to attempts at overcoming in a similar way the functional damage to the sound conducting mechanism of the middle ear in chronic otitis media.
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