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CSOM with Sclerotic Mastoids: Does Cortical Mastoidectomy Offer any Benefit Vis a Vis Graft Uptake and/or Hearing Outcome

CSOM with Sclerotic Mastoids: Does Cortical Mastoidectomy Offer any Benefit Vis a Vis Graft Uptake and/or Hearing Outcome

Tsewang Thinles, Shahid Rasool, Alyuza Saman, Ratna Priya

Journal Title:Acta Scientific Otolaryngology

Background: Chronic suppurative otitis media (CSOM) without cholesteatoma is a common diagnosis in otologic practice. Although opinions vary regarding the definition of chronic otitis media, most consider middle ear disease to be chronic if present for longer than 6 weeks. In cases of an actively discharging ear, it has been shown that mastoid exenteration frequently, but not always results in disease resolution. In quiescent chronic otitis media studies have shown that good outcomes are possible, irrespective of whether mastoidectomy was added to tympanoplasty or not.Objectives: Does mastoidectomy improves hearing and/or graft uptake rates in CSOM with sclerotic mastoids.Procedure: This is a prospective comparative study were patients with safe type of CSOM with dry ear for 1 month and having ra-diological evidence of mastoid sclerosis were included. Patients were divided randomly into two Group A and B with 32 and 40 cases respectively. Group A Patients underwent type 1 tympanoplasty with cortical mastoidectomy. While as Group B patients were offered standard type 1 tympanoplasty only.Results: The observations with respect to post-operative graft uptake rates in two groups under comparative study were quite simi-lar and comparable with p value of 0.873. Although the graft uptake rate in group A (84%) was seen on higher side compared to that in group B (80%). There was significant improvement in post-operative AB Gap in both groups with p value of < 0.0001. Moreover, no significant statistical difference was noted in post-operative AB Gap between the two groups at an average follow up period of 6 1/2 months. Conclusion: We concluded that mastoidectomy hardly offers any additional benefit with respect to graft uptake and hearing im-prove ment in sclerotic mastoids. So, the author doesn’t recommend the routine addition of mastoidectomy for sclerotic mastoid unless there are other compelling indications.Keywords: Sclerotic Mastoid; CSOM; Tympanoplasty; Cortical Mastoidectomy