Comparison between tympanoplasty with mastoidectomy and without mastoidectomy in
CSOM for maintaining dry ear
Dr Saad Khizer, Prof Dr Tallat Najeeb, Dr Sana Haroon
PAF Hospital Islamabad
ABSTRACT:
Background: Chronic Suppurative Otitis Media (CSOM) remained a common otologic condition associated with persistent ear discharge and hearing impairment. Surgical management, particularly tympanoplasty with or without mastoidectomy, had been widely practiced; however, the necessity of adding mastoidectomy for achieving a dry ear remained controversial.
Aim: This study aimed to compare the outcomes of tympanoplasty with mastoidectomy versus tympanoplasty without mastoidectomy in patients with CSOM in terms of achieving and maintaining a dry ear.
Methods: This comparative study had been conducted at Pakistan Institute of Medical Sciences (PIMS), Islamabad, from March 2025 to February 2026. A total of 90 patients diagnosed with CSOM were included in the study. Patients were divided into two groups: Group A (n=45) underwent tympanoplasty with mastoidectomy, while Group B (n=45) underwent tympanoplasty without mastoidectomy. Patients were selected using non-probability consecutive sampling. All patients were followed postoperatively for a period of three months to assess the primary outcome, which was achievement of a dry ear. Data were analyzed using appropriate statistical methods, and comparison between the two groups was performed.
Results: Out of 90 patients, successful dry ear was achieved in 40 patients (88.9%) in Group A (tympanoplasty with mastoidectomy) and in 36 patients (80.0%) in Group B (tympanoplasty without mastoidectomy). Although the success rate was slightly higher in the mastoidectomy group, the difference between the two groups was not statistically significant (p > 0.05). Postoperative complications were minimal and comparable in both groups.
Conclusion: Tympanoplasty with mastoidectomy had shown a slightly higher rate of achieving a dry ear compared to tympanoplasty alone; however, the difference was not statistically significant. Therefore, routine addition of mastoidectomy in all CSOM cases may not be necessary and should be considered on a case-by-case basis.
Keywords: Chronic Suppurative Otitis Media, Tympanoplasty, Mastoidectomy, Dry Ear, Otologic Surgery, Hearing Outcomes.