Abstract

Background: Cholesteatomatous otitis media is a surgical disease managed either by Intact Canal Wall (ICW) or Canal Wall Down (CWD) mastoidectomy, depending upon the extent of cholesteatoma. The status of the eustachian tube relates to the pathogenesis of cholesteatoma and affects the surgical outcome in terms of recurrence of the disease, postopera- tive audiological gain, and graft uptake rates.
Objective: To compare ICW against CWD mastoidectomies with tympanoplasty, in terms of hearing gain and graft uptake rates, based on the status of eustachian tube ( patent/ blocked ).
Materials and Methods: The study comprised of 50 patients , who underwent either ICW or CWD mastoidectomy with tympanoplasty in the department of Otorhinolaryngology, J N Medical College, A.M.U Aligarh from September 2010 to August 2013, with a mean follow-up of 18 months. The Eustachian tube was patent in 30 (60%) cases and blocked in 20 (40%) cases. Chi-square and unpaired t-tests were used to analyze the results. The p-value of <0.05 was considered to be significant.
Results: In ICW mastoidectomy with tympanoplasty, there is a significant difference in average audiological gain between patients with patent eustachian tube and those with blocked (p=0.022, t=2.63), while no significant difference was seen in graft uptake rate (p=0.629). While in CWD mastoidectomy group there was no significant difference between average audiological gain (p>0.05, t=1.73) and graft uptake rate (p=0.711), between patients with patent eustachian tube and those with blocked . Conclusion: The patency of eustachian tube plays a role in the outcome of mastoidectomies in regard to audiological gain.