Abstract
Tympanic membrane perforations are uncommon following the use of ventilation devices; however, persistent perforations should be given special attention for squamous epithelial growth through the perforation to the undersurface of the tympanic membrane. Surgical management is indicated in these cases. Tympanic membrane grafting procedures are adequate for early involvement. Successful grafting depends on excision of the tympanic membrane involved with the undersurface growth of squamous epithelium. Mastoid extension of the squamous tissue ingrowth requires greater surgical exposure. Cases and their management are presented.

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