A Comparative Study of Tympanoplasty with or without Mastoidectomy in Tubotympanic Type of Chronic Suppurative Otitis Media

Abstract

Background: One of the most frequent ear illnesses in underdeveloped countries is chronic suppurative otitis media (CSOM). In the treatment of CSOM, otolaryngologists debate whether to perform tympanoplasty with or without cortical mastoidectomy. Objective: To compare the outcome of tympanoplasty with or without cortical mastoidectomy in the treatment of tubotympanic type chronic suppurative otitis media. Methods: This comparative study was carried out in the Department of Otolaryngology - Head and Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from July 2017 to June 2019 over a period of 02 years. A total number of 60 patients who underwent type 1 tympanoplasty with or without cortical mastoidectomy were enrolled in this study. After enrollment the condition of the pinna, preauricular region, postauricular region and external auditory cannal were examined. On otoscopy, site and size of perforation of tympanic membrane, condition of the rest of the tympanic membrane, condition of the middle car mucosa and the ossicles were also examined. Tuning fork tests, test for facial nerve integrity and fistula test were performed. Hearing level was assessed by pure tone audiometry with masking. Enrolled patients were grouped into two groups. Patients who underwent type- 1 tympanoplasty alone kept in group A and who underwent type 1 tympanoplasty with cortical mastoidectomy kept in group B. Complete blood count, blood urea, serum creatinine, random sugar, ECG and X-ray chest P/A view were done routinely. Results: Females were 76.7% in group-A and 53.3% in group-B. All patients were of age between 16 to 60 years and most of them were in the age group of 21-30 years. Majority of the patients were from rural area and maximum patients were from middle class family. In most of the patients unilateral ear involvement was observed. Perforation site was central malleolar in maximum cases followed by anterior central and posterior central. Perforation size was ........