This series examines the results of myringoplasty in children using the overlay technique. Controversy still surrounds the issue of proper timing of surgery on the basis of preoperative assessment of tubal function. Results of this technique in children, using contralateral ear status as the primary predictor of success, found an overall success rate of 78%. Age appears to be a significant factor because children 10 years old and younger were found to have a higher incidence of surgical failures.

The goals of tympanoplasty are two: elimination of disease and permanent restoration of hearing. A planned two‐stage tympanoplasty is recommended to accomplish these goals in cases with extensive middle ear mucous membrane disease, in cases with absence of all ossicular tissue and in cases in which there is uncertainty regarding the eradication of cholesteatoma. The most satisfactory technique for restoring hearing in cases without ossicular tissue is a cartilage strut to the stapes footplate. To avoid post‐operative sensori‐neural impairment the surgeon should not open the labyrinth while removing middle ear and mastoid disease. Serious consideration should be given to mastoid re‐exploration for residual disease in all cases in which a closed technique is used for mastoid cholesteatoma. The. otologist must have a thorough knowledge of principles of tympanoplasty and must execute the surgical techniques precisely. By so doing, he should be able to restore useful hearing to the majority of his patients.

The expected success rate in primary stapedectomy is well documented in recent literature, but few reports have commented on the difficulties or the expected results in revision stapes surgery. Reports have dealt with different techniques, but the surgeon and the patients should be aware of the problems and risks involved in revision stapedectomy. The records of 35 patients who had undergone revision stapedectomy were analyzed to determine the following: 1. cause of failure, 2. how to avoid these difficulties, 3. hearing results, and 4. possible identifying factors which might pinpoint those patients with a high risk for sensorineural hearing loss. A review of these cases demonstrates that the results of revision stapedectomy are different than those for primary stapedectomy.

This review is a continuation of the series of 35 cases of carcinoma of the external auditory canal originally reported by the senior author and colleagues. Eighteen additional cases have been evaluated and treated since 1976. Preoperative high-resolution computed tomographic scanning has replaced polytomography, and improved surgical skull base approaches have allowed for extended resections of advanced lesions. A revised classification for local and extensive lesions is presented. The prognosis for localized tumors treated by en bloc resection remains excellent, whereas prognosis for extensive lesions might be more dependent on histologic type and grade of tumor.

Bioprosthetic oversizing impairs hemodynamic performance of aortic valve bioprostheses. The magnitude of this effect varies by valve model and size. Clinically, these data suggest that during aortic valve replacement, placing a valve whose internal orifice closely matches the aortic annulus will provide the optimal hemodynamic performance.