Comparative Evaluation of Tympanoplasty with and without Cortical Mastoidectomy in the Surgical Management of Tubotympanic Chronic Suppurative Otitis Media: Graft Success, Hearing, and Recurrence Outcomes

Introduction: Chronic suppurative otitis media (CSOM), particularly tubotympanic CSOM, is commonly treated with tympanoplasty. While adjunctive mastoidectomy is debated, studies show mixed results. This study compares tympanoplasty outcomes with and without mastoidectomy, evaluating graft success, recurrence rates, hearing improvement, and postoperative complications to inform treatment decisions for tubotympanic CSOM. Methods: This prospective hospital-based study at KIMS, Amalapuram, included patients aged 15-55 with chronic ear discharge and hearing loss. Participants underwent detailed clinical, otoendoscopic, and radiological evaluations. Pure tone audiometry assessed hearing loss, and statistical analysis using SPSS 20.0 and Excel 2010 evaluated outcomes with P<0.05 for significance. Results: The study found that tympanoplasty with corticomastoidectomy showed higher graft success (92.1% vs. 85.3%) and lower recurrence rates (6.3% vs. 12.5%) compared to tympanoplasty alone. Postoperative hearing improvements were better in the corticomastoidectomy group. Complication rates were similar in both groups. Significant differences were observed in graft success and recurrence rates (P<0.05). Conclusion: Tympanoplasty with corticomastoidectomy offers improved graft success and lower recurrence rates compared to tympanoplasty alone in the management of tubotympanic CSOM. While both approaches provide significant postoperative hearing improvements, tailored surgical strategies, including corticomastoidectomy, may enhance long-term outcomes for patients with CSOM.