MASTOIDECTOMY IN NONCHOLESTEATOMATOUS CHRONIC SUPPURATIVE OTITIS-MEDIA - IS IT NECESSARY

Chronic suppurative otitis media (CSOM) without cholesteatoma, the sur gical treatment of which is still controversial, is a common diagnosis in otologic practice. A retrospective analysis of 323 patients who un derwent surgery for noncholesteatomatous chronic otitis media in the G ruppo Otologica, Piacenza, Italy, between April 1983 and December 1993 is presented. Cases were separated into three groups according to dif ferent surgical treatment modalities and conditions of the ears at the time of operation, Group I (n = 53) consisted of cases of CSOM treate d by tympanoplasty without mastoidectomy (TLWOM), Group II (n = 28) in cluded cases of CSOM treated by tympanoplasty with mastoidectomy (TLWM ). Intact canal wall technique was used in these cases. The ears in bo th these groups were discharging severely at the time of surgery, Grou p III (n = 242) included patients whose ears were dry at the time of s urgery but who had had previous recurrent episodes of suppuration and who were treated by TLWOM. At the last follow-up, graft success rates for groups I, II, and III were 90.5%, 85.7%, and 89.2%, respectively a nd mean residual gaps were 17.2 dB, 20.1 dB, acid 19.4 dB, respectivel y. There was no statistically significant difference between the three groups either on graft success rates (p > 0.05) or on final functiona l hearing outcome (p > 0.05). TLWM is the preferable treatment modalit y for most surgeons in noncholesteatomatous CSOM. Nevertheless, in our experience TLWOM yields comparable results for this group of patients . In addition, we could not find any significant difference in results of graft success and final functional hearing rates between dry and d ischarging ears (p > 0.05).