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The atelectatic ear

Atelectasis of the tympanic membrane is a problem that occurs as a sequela of chronic otitis media with effusion. Abnormal pressure regulation and destruction of the fibrous layer of the tympanic membrane tend to contribute to the progression of this disease process. Atelectasis appears to be a fluctuating problem that sometimes resolves spontaneously. For patients in whom atelectasis progresses, treatment modalities include politzerization, insertion of ventilation tubes, and tympanoplasty with or without mastoidectomy. Treatment is reserved for patients with symptoms (eg, aural pressure), conductive hearing loss, or intractably pathologic conditions such as cholesteatoma. Our approach has been a tympanoplasty with enlargement and reconstruction of the middle ear and placement of ventilation tubes. This treatment addresses the pathogenesis that contributes to this disease.