Publication:

Tympanoplasty with and without cortical mastoidectomy in treatment of inactive mucosal chronic otitis media

Background Tympano-mastoidectomy has been found to be an effective method of treatment of chronic ear infection, but the effect of mastoidectomy on patients without evidence of active infectious disease in mastoid remains highly debated and unproven. Analyse the surgical outcomes of repair of uncomplicated tympanic membrane perforations with tympanoplasty alone and tympanoplasty combined with mastoidectomy.

Methods The present study was a prospective, comparative, randomized controlled trial in which 60 patients 30 in each groups via simple random sampling technique underwent tympanoplasty with cortical mastoidectomy. Temporalis fascia was used as graft in all the cases. All the surgeries were done by post aural route and underlay technique was used in all cases.

Results The overall graft uptake rate in our study was 88.33%. The graft uptake rate in tympanoplasty group was 87% and 90% in the tympanoplasty with cortical mastoidectomy group. There was no significant difference in the graft uptake rates of the two groups. There was no statistical significance between the two groups as p>0.05, suggesting that mastoidectomy when combined with tympanoplasty offers no benefit over tympanoplasty alone. There was no significant difference in hearing gain between the two groups as p value obtained was >0.05.

Conclusions Tympanoplasty alone is sufficient in patients with chronic inactive mucosal otitis media, as the results of the graft uptake and hearing improvement show no significant difference between the tympanoplasty group and the tympanoplasty with cortical mastoidectomy group.