[The common problems in sinuectomy and tympanoplasty].

The common problems encountered in the surgery for chronic otitis media and chronic paranasal sinusitis were discussed in this articles. "Preservation of the mucous membrane" , "Communication of these cavities with the proper nasal cavity or with the external auditory meatus", and " Obstruction of these cavities" As the result the author has been lead to conclude that it is unnecessary to remove the mucous membrane because the change of the mucous membrane is a result of inflammation and not a progressive pathological process. Therefore, removal of the mucous membrane is not jastified unless the membrane itself is the cause of clinical symptoms such as rhinorrhea, otorrhea and hearing impairment. Consequently, the routine dissection of the mastoid cells in tympanoplasty is notperformed by the author. Although it is rational to communicate the sinuses with the proper nasal cavity in sinuectomy, it is not reasonable to open the middle ear cavities, tympanum and mastoid cells to the external audi. tory meatus, as taught by meager history of the middle ear sugery. Attempt to obliterate only one of the middle ear and paranasal cavities, the frontal sinus or the mastoid cells for example, is meaningless from the point of whole treatment of chronic inflammation of these cavities, because the ethmoidal sinus cannot be obliterated in sinuectomy and the tympanum should not be obliterated in tympanoplasty.