Do patients with sclerotic mastoids require aeration to improve success of tympanoplasty?

Abstract

Conclusion: We could not find any significant difference in the results for graft success rate and functional hearing results between the myringoplasty and tympano-mastoidectomy groups. So mastoidectomy may not be necessary for successful tympanic membrane reconstruction and hearing improvement.

Objective: To investigate the effect of aerating mastoidectomy on the surgical success rate of myringoplasty.

Methods: This was a retrospective study. Data were analyzed from 92 patients who underwent surgical repair of tympanic membrane perforations due to chronic suppurative otitis media (CSOM) without cholesteatoma. Tympano-mastoidectomy was performed in 46 patients with a small sclerotic mastoid. The other 46 patients underwent myringoplasty without mastoidectomy. Patients were evaluated for success in tympanic membrane reconstruction and hearing levels after a minimum follow-up duration of 1 year.

Results: Tympanic membrane perforation closure was successful in 76.1% (n = 35) of the 46 patients undergoing myringoplasty and in 78.3% (n = 36) of the 46 patients undergoing myringoplasty with mastoidectomy. The difference between the closure rates of the two groups was not statistically significant (p > 0.05). The difference between the two groups for hearing gain was also not statistically significant (p > 0.05).