DOI: 10.36347/sjams.2019.v07i12.043

Pages: 4038-4043

Aims & Objectives: To assess whether removal of septic focus (adenoidectomy and/or tonsillectomy) only is sufficient in the management of mucosal type of chronic otitis media in paediatric age group or performing concomitant type I cartilage tympanoplasty gives better long term result in terms of closure of perforation, discharge free ear and hearing improvement. Materials & Methods: A prospective randomized clinical study took place at the Dept. of Otorhinolaryngology of a tertiary care hospital, over a period of one year amongst 43 patients, aged between 5 and 12 years, presenting with chronic otitis media with dry central perforation of ear-drum and pure conductive hearing loss with clinical and radiological evidence of chronic tonsillitis and/or adenoid hypertrophy. Patients were randomly divided into two groups. Group 1 (n1= 22) underwent type I cartilage tympanoplasty along with adenoidectomy and/or tonsillectomy in the same sitting and Group 2 (n2= 21) underwent adeno-tonsillectomy and conservative management of COM. Patients were followed up at 1, 3 and 6 months in post-operative periods. Results: 86.4% patients in group 1 (Type I cartilage tympanoplasty with concomitant adeno-tonsillectomy) had anatomic closure of tympanic perforation at 6 months post-operative follow up while that in group 2 (adeno-tonsillectomy alone) was found to be 42.86%. At the end of 6 months post-operative follow up, the mean hearing gain (pre-op A-B gap minus post-op A-B gap) in two groups were found to be 15.91±6.54 dB and 6.56±5.47 dB respectively. Conclusion: Removal of septic focus (adeno-tonsillectomy) has a definite role in the management of mucosal type of chronic otitis media in paediatric age group and when it is combined with type I cartilage tympanoplasty, it almost cures the disease.