THE ROLE OF CORTICAL MASTOIDECTOMY IN MYRINGOPLASTY FOR TREATMENT OF TUBOTYMPANIC CHRONIC OTITIS MEDIA IN ADULTS
Ahmed Mohamed El-Shiekh*, Mohamed Fathy Ramadan, Mohamed Hussein and Wael Fawzy Esmail
Background: there is no doubt that, surgical treatment of chronic suppurative otitis media is usually done by myringoplasty. However, the benefit of cortical mastoidectomy associated with myringoplasty remains a subject of debate. Aim of the work: to evaluate cortical mastoidectomy associated with myringoplasty in treatment of chronic suppurative otitis media. Patients and methods: seventy patients eligible for myringoplasty were randomly allocated to equal two groups: myringoplasty alone (M group) and myringoplasty associated with cortical mastoidectomy (MCM group). All patients were submitted to full history taking and otological examination, operated on dry ear via postauricular approach, temporalis fascia was put using the underlay technique. They were followed up for at least 6 months (the end point of the study). Results: both groups were comparable as regard to age, sex distribution, most common presenting symptom, preoperative, postoperative and air bone gap difference. Success of graft uptake was increased in MCM group (91.4%) versus M group (77.1%). But the difference was statistically non-significant. However, the dry ears were significantly increased in MCM group when compared to M group (91.4% vs 71.4% respectively). Conclusion: cortical mastoidectomy seems to express benefits when associated with myringoplasty as regard to dryness of ear at short-term follow up (6 months) and regard the rate of graft uptake success (but the difference was not significant). Future research on a wide number of patients with long-term follow up duration may finish the debate regarding cortical mastoidectomy associated with myringoplasty for chronic suppurative otitis media.
Keywords: myringoplasty, tympanostomy, mastoidectomy, otitis media.
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