EVALUATION OF MIDDLE EAR CLEFT STATUS IN PATIENTS OF TUBOTYMPANIC SAFE TYPE OF CSOM UNDERGOING TYMPANOPLASTY WITH CORTICAL MASTOIDECTOMY

Introduction: In Inactive mucosal CSOM (Dry perforation), there is a permanent defect of the tympanic membrane, with no active infection or pus discharge. Such an ear may remain inactive, become active, or occasionally heal. This study evaluates the prevalence of hidden diseases in such patients, specically inammatory changes in the middle ear cleft, undergoing Tympanoplasty with Cortical Mastoidectomy, and estimates the frequency of occurrence of disease at various sites in the middle ear cleft among the same population. Methodology: A prospective observational study was conducted at a tertiary referral Centre from October 2022 to April 2023. The study was conducted among 50 participants with inactive mucosal chronic otitis media who were undergoing Tympanoplasty with cortical mastoidectomy. All intraoperative ndings of the middle ear cleft space, including tympanosclerosis, mucosal hypertrophy, granulation tissue, ossicular chain status, and patency of the aditus, were recorded. Result: We observed that the prevalence of hidden disease in the middle ear cleft in the tubotympanic safe type of CSOM was 54%. In which granulation tissue, mucosal hypertrophy, and tympanosclerosis are seen in 26.1%, 15.9%, and 13% of subjects, respectively. The most common site of occurrence of granulation tissue was the mastoid air cells, 26%, followed by the attic and antrum, 16% each. Out of 50 participants, aditus blockage was seen in 40%, intraoperative mucoid discharge in 44%, and necrosis of the long process of incus in 24%. Conclusion: Therefore, for optimal surgical results, it is necessary to clear the disease from the mastoid air cells and attic region, which is the most common site of disease occurrence.