An analysis is presented of a series of 434 operations in chronic otitis media in children taking into account the extent of the lesion, the type of operation, the early and late functional and morphological results. In 18% of cases a radical operation was performed, in 21 % atticotomy or other conservative operations, and in 61 % open or closed tympanopiasty. Because of dynamic character of the cholesteatomatous process in childhood, the creation of a ‘safe ear’, i.e. free of recurrences of cholesteatoma, is difficult by means of closed tympanopiasty operati