Experiences with type IV tympanomastoidectomy.

Tye IV tympanoplasty was performed on 72 patients having advanced suppurative disease of the middle ear and mastoid with total loss of the middle ear sound transmission system. The principal features of the method consist of a postauricular wide-field mastoidectomy, canalplasty, meatoplasty, Type IV tympanoplasty with cutaneous exteriorization of the footplate and mastoid obliteration. The method achieved a postoperative bone-air gap of 30 db or less in 59 percent of cases with a 15 percent incidence of recrudescence requiring some further surgery.