DOI: https://dx.doi.org/10.18203/issn.2454-5929.ijohns20220140
Published: 2022-01-25

A comparative study to evaluate the postoperative results between tympanoplasty alone and tympanoplasty with cortical mastoidectomy in chronic suppurative otitis media

Kiran Naik, Ravi K. S.

Abstract


Background: Chronic suppurative otitis media (CSOM) is a common ear disease presenting to the ENT OPD. It’s the most common cause of hearing dysfunction in our country. Most of these cases requires surgery but still controversial. In the surgical management of CSOM even well experienced otologist have the dilemma whether to combine mastoidectomy with tympanoplasty or not. Objectives of the study was to study and evaluate whether the additional mastoidectomy procedure helps in the outcome in the surgical treatment of CSOM in terms of graft uptake, perforation closure, improvement in hearing, disease eradication and recurrence.

Methods: The 40 patients of age group 12 to 65 years diagnosed with CSOM of tubotympanic type in inactive or quiescent stage was taken as study group. Tympanoplasty alone was done in 20 cases and tympanoplasty with cortical mastoidectomy was done in 20 cases. Hearing gain following surgery and factors influencing the outcome were measured. Study done was prospective comparative study.

Results: Graft uptake was seen in 17 cases (85%) in tympanoplasty alone group and 15 cases (75%) in Tymapanomastoidectomy group at the end of 2nd month. Graft uptake was found to be same in terms of significance in both groups. Post-operative hearing gain was observed in 75% of patients in each group

Conclusions: Hearing improvement, graft uptake were statistically incomparable in two groups. Combining cortical mastoidectomy with tympanoplasty will not give additional benefits in terms of hearing gain, graft uptake and disease eradication if the middle ear mucosa is healthy.


Keywords


CSOM, Central perforation, Tympanoplasty, Cortical mastoidectomy, Pure tone audiometry

Full Text:

PDF

References


Jahn AF, Chronic otitis media: diagnosis and treatment. Med Clin North Am. 1991;75(6):1227.

Nagale SK, Jagade MV, Gandhi SR, Pawar PV. Comparative study of outcome of type I tympanoplasty in dry and wet ear. Indian J Otolaryngol Head Neck Surg. 2009;61:138-40.

Mahmud K, Faruque M, Faisal K. A Study on Type-1 Tympanoplasty in Perforated Ear Drum. J Dhaka National Med College Hospital. 2013;18(2):14-6.

Chonmaitree T, Revai K, Grady JJ. Viral upper respiratory tract infection and otitis media complication in young children. Clin Infect Dis. 2008;46(6):815-23.

Naderpour M, Shahidi N, Hemmatjoo T. Comparison of Tympanoplasty Results in Dry and Wet Ears. Iran J Otorhinolaryngol. 2016;28(3):209-14.

Rickers J. Long-term follow-up evaluation of mastoidectomy in children with non-cholesteatomatous chronic suppurative otitis media. Int J Pediatr Otorhinolaryngol. 2006;70:711-5.

Krishnan A, Reddy EK, Chandrakiran C, Nalinesha KM, Jagannath PM. Tympanoplasty with and without cortical mastoidectomy-a comparative study. Indian J Otolaryngol Head Neck Surg. 2002;54:195-8.

Tawab A. Myringoplasty with and without cortical mastoidectomy in treatment of non cholesteatomatous chronic otitis media: A comparative study. Clin Med Insights: Ear, Nose Throat. 2014;7:19-2.

Girde H, Gawarle SH, Keche PN. A Comparative Evaluation between Tympanoplasty with or Without Cortical Mastoidectomy. Int J Biomed Adv Res. 2017;8(7):275-8.

Mishiro Y, Sakagami M, Takahashi Y. Tympanoplasty with and without mastoidectomy for noncholesteatomatous chronic otitis media. Eur Arch Otorhinolaryngol. 2001;258(1):13-5.

Agrawal A, Bhargava P. Comparative Evaluation of Tympanoplasty with or Without Mastoidectomy in Treatment of Chronic Suppurative Otitis Media Tubotympanic Type. Indian J Otolaryngol Head Neck Surg. 2017;69(2):172-5.

McGrew BM, Jackson G, Glascock ME III. Impact of mastoidectomy on simple tympanic membrane perforation repair. Laryngoscope. 2004;114:506-11.