Abstract
Objective
To determine the clinical presentation and out come of Mastoidectomy in
Chronic Suppurative Otitis Media (CSOM).
Patients and Methods
This prospective interventional descriptive study was conducted in the departments of Otolaryngology and Pediatrics, Ghulam Muhammad Mahar Medical College Hospital at Shaheed Mohtrama Benazir Bhutto Medical University, Sukkur, Pakistan from June 2007 to June 2011. Sixty consecutive patients of age 5-50 years included in the study presented with CSOM. Pertinent clinical history and examination, investigations, and outcome of mastoidectomy were noted.


Results
Out of 60 patients, the most affected age group was between 11-20 years and 36 (60%) were female. All patients had chronic discharging ears and conducting deafness. Six (10%) cases had severe degree of hearing impairment greater than 50 dB loss, 45(75%) cases had moderate degree of hearing impairment (31to 50 dB) while 9 (15%) had mild hearing impairment less than 30 dB loss. Subtotal tympanic membrane perforation was seen in 30 (50%) cases followed by central type of perforation in17 (28%) patients. Thick odorous discharge was present in 30 (50%) followed by purulent discharge in15 (25%) cases.
In 45 (75%) cases, canal wall down mastoidectomy was carried out without tympanoplasty. In 15 patients, mastoidectomy with tympanoplasty was done and these were excluded from the study. The surgical approach was post aural in all cases. The granulation tissue (granuloma) was present in 38 (63.5%) and cholesteatoma in 22 (36.5%) cases in middle ear cavity. The dry ear was in 32 (80%) and 8 (20%) patients has discharging ear at the end of 2 month follow-up. Recurrence of granulation tissue was found in 7 (17.5%) patients and cholesteatoma in 3 (7.5%) patients at the end of follow up.
Conclusion
CSOM was in poor socio economic class and was associated with moderate degree of hearing loss in most of the patients. Mastoidectomy was effective in controlling the recurrence of granulation tissue, choesteatoma and otorrhea to a greater extent. (Rawal Med J 2012;37:50-53).

Key words: CSOM, hearing loss, granulation tissue and cholesteatoma.