Objectives: To compare the results of tympanoplasty alone and tympanoplasty with cortical mastoidectomy in chronic suppurative otitis media (CSOM) patients with sclerotic bone in terms of graft uptake, perforation closure, improvement in hearing and disease eradication. Study Design:Retrospective study of patients at tertiary referral hospital. Method: 50 cases of non-cholesteatomatous chronic suppurative otitis media were selected. Tympanoplasty alone was done in 25 cases and tympanoplasty combined with cortical mastoidectomy was done in another 25 cases. Patients were reviewed postoperatively at 4, 8 and 12 weeks to inspect the operated ear for graft uptake or any complication. Pure tone audiometry(PTA) was done at 2 nd and 4 th month to evaluate the hearing improvement.Results: In our study, hearing gain in decibel ( dB ) in tympanoplasty group was 7.64 and in tympanoplasty combined with cortical mastoidectomy was 8.84. Graft uptake was 76% in tympanoplasty group and 88% in tympanoplasty combined with cortical mastoidectomy. Recurrence of discharge was seen in 2 cases of tympanoplasty. Though tympanoplasty combined with cortical mastoidectomy is better in hearing improvement, graft uptake and clinical improvement but the difference in 2 groups is statistically insignificant. Conclusion:Hearing improvement, graft uptake and clinical improvement were statistically incomparable in 2 groups. Combining cortical mastoidectomy with tympanoplasty will not give additional benefits in terms of hearing gain, disease clearance and graft uptake.

BACKGROUND Chronic suppurative otitis media has been traditionally defined as a chronic inflammation of the middle ear and mastoid, usually associated with perforation of the tympanic membrane and otorrhoea. Understanding the pathology and pathogenesis of chronic suppurative otitis media is important in predicting the management, prognosis and sequelae of the disease. MATERIALS AND METHODS The present study was a cross-sectional study that was conducted to evaluate the clinical, intraoperative and histopathological changes in the middle ear cleft. 50 patients diagnosed with CSOM, who underwent surgery were taken. The mucosa and granulation tissue were removed along with ossicles wherever indicated and sent for histopathological examination. RESULTS Incidence of CSOM is highest in 3 rd decade of age with more prevalence in lower socioeconomic group. Females were involved more than males. Unilateral involvement was seen in 64% cases. Otorrhoea and diminished hearing was a constant feature among all cases followed by earache (26%), itching (22%), tinnitus (16%), vertigo (10%) and mass in the ear (6%). On otoscopic examination perforation was seen in 42 cases (84%), while retraction pockets were seen in 8 cases (16%), 7 cases had plastered TM (14%), tympanosclerosis was also found in 6 cases (12%), granulations in 2 cases (4%) and polyp was found in 3 cases (6%). On pure tone audiometry testing, 44 patients (88%) had conductive hearing loss and 6 patients (12%) had mixed hearing loss. CONCLUSION Main conclusion drawn from this study is that on clinical examination 38 cases were found to be of tubotympanic type and 12 cases of atticoantral variety. However, intraoperatively, of the tubotympanic cases, 4 were found to be of unsafe type, which was also proven histologically.