A comparative study of myringoplasty versus cortical mastoidectomy with type I tympanoplasty in tubotympanic chronic suppurative otitis media

Background: Chronic suppurative otitis media (CSOM) of the tubotympanic (mucosal) type is a common cause of preventable conductive hearing loss in developing countries. Although myringoplasty remains the standard surgical treatment for dry ears, the role of cortical mastoidectomy combined with type I tympanoplasty in improving anatomical and functional outcomes continues to be debated, particularly in patients with persistent mucosal disease. Objective was to compare the anatomical and audiological outcomes of myringoplasty versus cortical mastoidectomy with type I tympanoplasty in patients with tubotympanic (mucosal) CSOM. Methods: This prospective comparative interventional study was conducted at a tertiary care centre in rural Telangana over an 18-month period. Eighty patients aged 18 to 65 years with tubotympanic CSOM were enrolled and allocated into two groups: group A (myringoplasty, n=40) and group B (cortical mastoidectomy with type I tympanoplasty, n=40). Baseline demographic variables, disease characteristics, and preoperative air-bone gap (ABG) were comparable between groups. Primary outcome measures included graft uptake and postoperative ear status, while secondary outcomes included audiological improvement assessed by ABG closure and hearing gain. Statistical analysis was performed using appropriate parametric and non-parametric tests, with p