Role of Tympanomastoidectomy in Dry Tubotympanic Chronic Otitis Media

Chronic otitis media (C.O.M), safe or tubotympanic type, is now classified as non-squamosal or mucosal otitis media. As far as it's surgical management is concerned, opinion remains divided between tympanoplasty alone versus tympanoplasty combined with cortical mastoidectomy. The purpose of this study is to compare the outcome between these two surgical modalities in dry tubotympanic disease.

Prospective randomized study in a tertiary referral hospital.

60 patients of dry tubotympanic ear disease were taken up for the study. These patients were randomized by dividing them alternately into two groups, Group A (tympanoplasty) and group B (tympanomastoidectomy). All the patients underwent surgery under similar circumstances as per their allotted group. The results were analyzed at 3 weeks, 6 weeks and 3 months postoperatively. The success rate of the surgery was judged by the graft uptake and hearing gain as the end points at the end of 3 months.

The mean age was 33.33 years with male preponderance. The X-ray mastoid Schuller's view showed sclerotic mastoid in 27(45%)cases. 30 cases were operated by doing tympanoplasty alone and other 30 cases were operated by tympanoplasty with cortical mastoidectomy. The success rate of graft uptake was 83.33% in cases with tympanoplasty alone as compared to 86.67% in tympanoplasty with cortical mastoidectomy at 3 months follow up. The A-B gap closure was 12.7 and 16 db respectively in the two groups. The difference between both the parameters being statistically insignificant, the additional benefit of mastoidectomy seems insignificant.