One of the major problem in otology today is maintaining aerated middle space when there is malfunction of the eustachian tube. The "closed technical" preserved the anatomy of the external and middle ears, but unknown the persistent non function of the eustachian tube. Also, in cholesteatoma a permanent aerating tube is utilised at the time of the initial surgery. The tube is placed through hale drilled in the attical boy canal wall, over the head of the malleus. The "trans attical tube" is found to be a valuable adjuction in intact canal wall tympanoplasty for hearing improvement and to reduce the incidence of a retraction pocket.
Adult Ear