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 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.

The objective of the work is to improve the efficacy of the treatment of patients with chronic otitis media with the tympanic cavity epidermization. The authors suggested the new methods of surgical treatment of these patients based on the developed valve mechanism of the tympanic cavity ventilation and formation of reliable new membrane tympanum resisting retraction and re-atresia of the newly created air cavity. The article provides a detailed analysis of the results of surgical treatment of these patients in the primary (treatment according to the newly developed techniques) and control (treatment according to the previously developed, conventional techniques) groups. The authors designed and presented an algorithm of medical rehabilitation of patients with chronic otitis media with tympanic cavity epidermisation.

This article defines the terms “tympanum revision” and “revision tympanotomy”, presenting the criteria of differentiation thereof. The term “revision” means exploration (inspection), control tympanotomy or tympanum re-inspection, re­operation in cases of disputable results of primary surgery, aimed at checking (making visual inspection, control) of the tympanic cavity structures. To indicate the primary tympanotomy when the disease diagnosis is complicated, the term “diagnostic”, “exploratory” tympanotomy or “tympanotomy with the tympanic cavity revision” is preferable. The authors presented their vision of use of the terms “revision”, “repeated sanitizing” or “reconstructive” surgery, depending on surgical findings and the nature of cholesteatomic process during the primary surgical intervention.

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