Comparative evaluation of surgical and audiological outcomes in patients of chronic suppurative otitis media with dry ear treated by myringoplasty with or without simple mastoidectomy


  • Amanjot Kaur Department of ENT, BFUHS, Punjab
  • Vinod M.K. Department of ENT, BFUHS, Punjab
  • Jagdeepak Singh Department of ENT, BFUHS, Punjab
  • Baldev Singh Department of ENT, BFUHS, Punjab
  • Priyanka . Department of ENT, BFUHS, Punjab
  • Simranjit Kaur Department of ENT, BFUHS, Punjab



Surgical and audiological outcomes, CSOM treated by myringoplasty with or without simple mastoidectomy


Background: The study was conducted to compare and evaluate surgical and audiological outcomes in patients of chronic suppurative otitis media with dry ear treated by myringoplasty with or without simple mastoidectomy. Prospective, open label, randomized, comparative  study, conducted  in the Department of ENT, Ram Lal Eye and ENT hospital, Government Medical College Amritsar, Punjab, India.

Methods: This study comprised of 40 patients aged between 15 to 50 years having CSOM (safe type) with dry ears for the last 3 months. Patients were randomly divided into Group A treated with myringoplasty alone and Group B with standard simple mastoidectomy along with myringoplasty using temporalis fascia graft by underlay technique. Patients also subjected to routine hematological, biochemical, radiological and audiological investigation. The audiological comparison done before and after surgery.  

Results: It was observed that graft uptake rate was better in group B. The average gain in air conduction threshold was more in patients who had undergone myringoplasty along with simple mastoidectomy. However this was not statistically significant. There was no significant improvement observed in the AB Gap in our patients who underwent myringoplasty or simple mastoidectomy along with myringoplasty.

Conclusions: Hypocellularity of the mastoid process has a strong correlation with the tubotympanic type of CSOM. Addition of mastoidectomy to simple myringoplasty has a very little beneficial effect on the postoperative hearing gain and graft uptake as it showed no much statistical significance.


ahn AF. Chronic otitis media: diagnosis and treatment. Med Clin North America. 1991;75(6):1227

Gleeson MJ, Clarke RC. Scott-Brown's Otorhinolaryngology: Head and Neck Surgery 7 th edition. Volume 3. CRC Press; 2008.

Jackler, Schindler. Myringoplasty with simple mastoidectomy: Results in eighty two consecutive patients. Otolaryngol Head Neck Surg. 1983;91(1):14 -7.

Holmquist J, Bergstorm B. Mastoid air cell system in ear surgery. Arch of Otolaryngol Head Neck Surg. 1978;104(3):127–9.

Chavan S, Deshmukh S, Pawar V, Kirpan V, Khobragade S, Sarvade K. Tympanoplasty with and without cortical mastoidectomy for tubotympanic type of chronic suppurative otitis media. Otolaryngol Head Neck Surg. 2011;8(1):8-10.

Nayak DR, Balakrishnan R, Hazarika P, Mathew PT. Role of cortical mastoidectomy in the results of myringoplasty for dry tubotympanic disease. Indian J Otol. 2003;9:11-5.

Ashok KS, Munsi DM, Ghosh SN. Evaluation of improvement in type1 tympanoplasty and its influencing factors. Indian J Otolaryngol Head Neck Surg. 2006;58(3):253-7.

Mishiro Y, Sakagami M, Takahashi Y, Kitahara T, Kajikawa H, Kubo T. Tympanoplasty with and without mastoidectomy for non-cholesteatomatous chronic otitis media. European Arch Oto-Rhino-Laryngol. 2001;258(1):13-5.

Krishnan A, Reddy EK, Nalinesha KM, Jagannath PM. Tympanoplasty with or without cortical mastoidectomy-a comparative study. Indian J Otolaryngol Head Neck Surg. 2002;54(3):195-8.

Balyan FR, Serdar, Celikkanat, Aslan A, Taibah A, Russo A and Sanna M. Mastoidectomy in non-cholesteatomatous chronic suppurative otitis media: Is it necessary? Otolaryngol Head Neck Surg. 1997;177(6):592-5.

Toros SZ, Habesoglu TE, Habesglu M, Bolukbasi S, Naiboglu B, Karaca CT and Egele E: Do patients with sclerotic mastoids require aeration to improve the success of tympanoplasty? Acta Otolaryngol Supp. 2010;130(8):909-12.

McGrew B.M., Jackson CG, Glasscock ME. Impact of mastoidectomy on simple tympanic membrane perforation. Laryngoscope, 2004;114(3):506-11.

Carrillo RJ, Yang NW, Abes GT. Probabilities of ossicular discontinuity in chronic suppurative otitis media using pure-tone audiometry. Otology & Neurotology. 2007;28(8):1034-7.

Jackler RK, Schindler RA. Role of the mastoid in tympanic membrane reconstruction. Laryngoscope. 1984;94:495-500.

Lau T, Tos M. Long term results of surgery for chronic granulating otitis media. Am J Otolaryngol. 1986;7:341-5.






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