Surgical outcome of central perforation in tympanoplasty with and without cortical mastoidectomy

Introduction: Otitis media is defined as “an inflammation of the middle ear without reference to etiology or pathogenesis. Otitis media also implies concomitant inflammation, to a greater or lesser extent mastoid air cell system, owing to its anatomic linkage to the middle ear cleft i.e. the tympanic cavity Aim & Objective: To analyze and compare the surgical outcome of tympanoplasty with and without cortical mastoidectomy in central perforation C.S.O.M. (TTD) type. To assess the role of cortical mastoidectomy in the management of C.S.O.M. (TTD) type. Study Design : A prospective comparative study comprising of 50 patients who were randomly divided into two equal groups according to the inclusion and exclusion criteria as given below with 25 patients undergoing type 1 Tympanoplasty and 25 patients undergoing type 1 Tympanoplasty with cortical mastoidectomy, done over 2 years from july 2006 to july 2008 at Sri Ramachandra University, Chennai. Conclusion: • Cortical mastoidectomy is recommended in patients of CSOM (TTD) with subtotal perforation (involving all the quadrants). • The graft take up rate is similar in both the groups in patients with central perforation (involving one or two quadrants). • In successful graft take up, results of hearing improvement and graft mobility are similar with and without mastoidectomy. • Possibility of finding mastoid antral pathology is more in patients with CSOM (TTD) with subtotal perforation as observed in this study.