Chronic eustachian tube dysfunction contributes to many chronic middle ear diseases and to early and late surgical failures. Furthermore, surgeons may overlook air passage obstructions from the mesotympanum to the mastoid cavity. To date, long-term ventilation of the middle ear is the most practical technique of bypassing stubborn eustachian tube and middle ear ventilatory malfunctions. I present the techniques used to overcome and bypass tubal and intratympanic obstructions in 8% of operated ears in the past 6 years.
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