Group A - Myringoplasty (n=300):
Out of 300 cases onlay grafting was done in 172 cases and inlay grafting was done in 128 cases. The tragal perichondrium and catilage was the choice graft used with excellent post of results. The success rate was 96% and failures 4% in this group. The hearing gain with SRT was achieved within 15 dB AB gap closure. The failure of 4% were subjected to revision surgery. The dry and healed middle ear was seen within three months time. The failure cases were attributed to infection, unhygienic conditions and poor follow–ups. To infection, prosthesis displacement and extrusion of graft. Audiometric thresholds revealed 15–20 dB A–B gap closure. The follow up was achieved in 50% of cases for 2 to 4 years.

Group B– Ossiculoplasty (n=110) (Fig.1–6):
In this group all cases were subjected for tympanomastoidectomy with ossicular reconstruction by tragal cartilage and perichondrium struts of various types as L–shape, Bow–shape and Boomrang strut. Various combinations of Incudo–stapedial assembly, malleo–stapes strut, malleo–footplate assemblies were done. In all cases sialistic sheet was used so also the anterior canal skin as covering the graft assembly. In this group the success rate was 84% and failure rate was 16%. The failures were due to infection, prosthesis displacements and extrusion of the graft. Audiometric thresholds revealed 15–20 dB A–B gap closure. The follow up was achieved in 50% of cases for 2 to 4 years.


Group C– Osseusplasty (attic, PSQ, PCW, annular defects) (n=70):
In this group the various defects of attic, posterosuperior quaderants, posterior canal wall and annular defects were closed by tragal perichondrium and cartilage grafts. The composite graft proved to be the best than nonbiological grafts in takeup and restoring dry ears. The cholesteatoma from the defect was removed and the defect was closed with the grafts. The posterior canal wall defect was reconstructed with the tragal cartilage graft and lined by perichondrum and anterior canal wall skin. This group achieved 75% success rate and 25% were failures which needed revision surgery.

Group D– Mastoid obliterations (n=120):
All mastoid cavities were preoperatively treated by suction clearance, dry mopping with antifungal and antibiotic drops for about 4–6 weeks. The cavities were fashioned by smooth drilling and removing all debris, pockets of cholesteatomas etc. the tragal cartilage was arranged in the palisade manner with the perichondrium coverage and the pedicled temporalis muscle was swinged to obliterate the mastoid cavities for good healing. Periodical follow up and aural toilet were done. The cavities re–epithelised well and achieved 70% success rate. 30% failures was because of infection and poor post op. follow ups. The modified radical mastoidectomy cavities were transformed into radical cavities to achieve good healing. The problems of mastoid cavities are still unresolved despite the treatment of various modified techniques being weak.

Table I – Age group in the study:

Age group (years)	No. of cases	Percent
15–25	168	28
25–35	264	44
35–45	120	20
45–55	48	08
Total	600	100

Table II: Sex distribution:

Age group (years)	Male (no.)	Female (no.)	Total
15–25	108	60	168
25–35	120	144	264
35–45	72	42	120
45–55	24	24	48
Total	324	276	600
Percent	54	46	100

Table III – Surgical approaches:

Approaches	No. of cases	Percent
Endaural	312	52
Endomeatal	192	32
Postaural	60	10
Transtympanic	36	06
Total	600	100

Table IV – Anaesthesia:

Anaesthesia	No. of cases	Percent
General	120	20
Local + Sedation	480	80
Total	600	100

Table V – Pathological defects:

Type of Pathology	No. of Cases	%
Performation	240	40
Adhesive Otitis media	24	04
Tympanosclerosis	36	06
Retration pocket	180	30
Cholesteatoma	120	20
Total	600	100