SURGICAL SOLUTION FOR THE DIFFICULT CHRONIC EAR

We all encounter them: difficult chronic ears that seem to confound ma nagement efforts and that constitute an unrelenting imposition to the patient. Typically these ears have undergone multiple surgeries and ar e chronically infected. Such cases are commonly associated with residu al or recurrent cholesteatoma. Those rare ears that temporarily respon d to therapy promptly recur once treatment is withdrawn. Even the most aggressive nonsurgical protocols fail these patients, who exhibit lif elong social and professional incapacity. They seem to ultimately defy resolution. The purpose of this article is to present a surgical solu tion to the difficult chronic ear dilemma that emphasizes disease cont rol. Treatment outcome is reviewed in 541 cases. Management pitfalls a re analyzed with follow-up, in some cases 20 years.