Comparision of graft uptake and audiological outcomes in dry and wet ears with chronic suppurative otitis media; a prospective observational study

Background: Chronic otitis media (COM) is a routinely occurring health problem that causes a multitude of symptoms ranging from purulent ear discharge to reduced human functionality due to impaired hearing. This study is done to determine the rate of graft uptake and post operative hearing improvement in dry and wet ear in mucosal COM, where dry group had no discharge for >3 months and “wet” group comprised patients with scanty mucoid/mucopurulent discharge at the time of surgery. In our study, patients of age <18 years and >55 years, squamous COM, complications and revision tympanoplasty were excluded. All 50 cases underwent Underlay Type-1 Tympanoplasty with the use of temporalis fascia for neo-tympanum reconstruction. The graft uptake and improvement in hearing were compared based on otoscopic findings and pure tone audiograms at second and third months post-operatively. Intact graft was seen in 22 patients in dry (88%) and 20 patients in wet group (80%). 3 in dry and 5 in wet group showed residual perforation. Graft uptake rate was better in dry group, but not statistically significant. Results : Pre-operatively, mean pure tone threshold (PTT) in wet and dry groups was 31.6 dB and 31.8 dB respectively. In the second post-operative month, mean PTT was 22.4 dB in wet and 21.2 dB in dry groups. After 3 months, mean PTT of 20.6 dB in wet and 21 dB in dry group was observed. Hearing improvement was seen in 88% cases in dry ear and 80% in wet ear, but p value yet again showed no statistical significance. Conclusion: presence of discharge in the ear at the time of surgery does not interfere with the success rate of type-1 tympanoplasty in terms of re-epithelialization of graft and subsequent establishment of improved audiological function