CC BY-NC-ND 4.0 · Annals of Otology and Neurotology 2022; 05(02): 055-061
DOI: 10.1055/s-0043-1764174
Original Article

Surgical Outcome in Patients Undergoing Tympanoplasty Alone for Active Chronic Otitis Media Mucosal Type in Hilly Area

1   Department of Otorhinolaryngology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
Abhijeet Bhatia
1   Department of Otorhinolaryngology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
Nirupam Bhattacharjee
1   Department of Otorhinolaryngology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
› Author Affiliations


Introduction Chronic otitis media (COM) is a common problem affecting 65 to 330 million population worldwide with 50% patients suffering from hearing impairment. In active COM, the usual clinical practice is to wait for the ear to become dry and to consider tympanoplasty with/without cortical mastoidectomy. If cortical mastoidectomy can be avoided without compromising the outcomes, it is desirable. Various prognostic factors have been studied; however, the effect of altitude on the outcome of tympanoplasty has not been commonly studied. High-altitude areas can have poor connectivity and can result in middle ear pressure changes when the patients commute from low-altitude areas.

Aim The aim of this article was to assess the surgical outcome in patients undergoing tympanoplasty for active COM mucosal type in comparison to inactive COM mucosal type in a hilly area located at an altitude of 4,757 ft (1,450 m).

Objective This article compared the success rate and audiometric improvement in patients undergoing tympanoplasty for active COM mucosal type and inactive COM mucosal type.

Materials and Methods This prospective cohort study included 24 patients with 12 patients each in active and inactive groups. At 3 months follow-up, there was significant improvement in all the air conduction threshold frequencies and air bone gap in both the groups.

Conclusion The success rate for our tympanoplasties for active and inactive COM performed in a hilly area was 92% and it was comparable to those reported from other centers. Altitude may not negatively affect the outcome of tympanoplasty and that the active ear COM can have similar success rate as inactive COM tympanoplasty.

Publication History

Article published online:
26 May 2023

© 2023. Indian Society of Otology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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  • References

  • 1 Scott-Brown’s Otorhinolaryngology and Head and Neck Surgery. Volume 2: Paediatrics, The Ear and Skull base. 8th ed. Boca Raton, FL: Routledge & CRC Press; 2018
  • 2 Esposito S, D’Errico G, Montanaro C. Topical and oral treatment of chronic otitis media with ciprofloxacin. A preliminary study. Arch Otolaryngol Head Neck Surg 1990; 116 (05) 557-559
  • 3 Alper CM, Kitsko DJ, Swarts JD. et al. Role of the mastoid in middle ear pressure regulation. Laryngoscope 2011; 121 (02) 404-408
  • 4 Agrawal A, Bhargava P. Comparative evaluation of tympanoplasty with or without mastoidectomy in treatment of chronic suppurative otitis media tubotympanic type. Indian J Otolaryngol Head Neck Surg 2017; 69 (02) 172-175
  • 5 Glasscock-Shambaugh Surgery of the Ear. 6th ed. People’s Medical Publishing House-USA. 2010
  • 6 Mohammed Abdel Tawab H, Mahmoud Gharib F, Algarf TM, ElSharkawy LS. Myringoplasty with and without cortical mastoidectomy in treatment of non-cholesteatomatous chronic otitis media: a comparative study. Clin Med Insights Ear Nose Throat 2014; 7: 19-23
  • 7 Kamath MP, Sreedharan S, Rao AR, Raj V, Raju K. Success of myringoplasty: our experience. Indian J Otolaryngol Head Neck Surg 2013; 65 (04) 358-362
  • 8 Google Earth. Accessed August 27, 2021, at:
  • 9 Gurgel RK, Jackler RK, Dobie RA, Popelka GR. A new standardized format for reporting hearing outcome in clinical trials. Otolaryngol Head Neck Surg 2012; 147 (05) 803-807
  • 10 Degree of Hearing Loss. American Speech-Language-Hearing Association. Accessed January 27, 2023, at: /public/hearing/degree-of-hearing-loss/
  • 11 Naderpour M, Jabbari Moghadam Y, Ghanbarpour E, Shahidi N. Evaluation of factors affecting the surgical outcome in tympanoplasty. Iran J Otorhinolaryngol 2016; 28 (85) 99-104
  • 12 Tan HE, Santa Maria PL, Eikelboom RH, Anandacoomaraswamy KS, Atlas MD. Type I. Type I tympanoplasty meta-analysis: a single variable analysis. Otol Neurotol 2016; 37 (07) 838-846
  • 13 Shankar R, Virk RS, Gupta K, Gupta AK, Bal A, Bansal S. Evaluation and comparison of type I tympanoplasty efficacy and histopathological changes to the tympanic membrane in dry and wet ear: a prospective study. J Laryngol Otol 2015; 129 (10) 945-949
  • 14 Shishegar M, Faramarzi M, Rashidi Ravari M. Evaluation of middle ear risk index in patients undergoing tympanoplasty. Eur Arch Otorhinolaryngol 2019; 276 (10) 2769-2774
  • 15 Salviz M, Bayram O, Bayram AA. et al. Prognostic factors in type I tympanoplasty. Auris Nasus Larynx 2015; 42 (01) 20-23
  • 16 Sharma Y, Mishra G, Patel JV. Comparative study of outcome of type i tympanoplasty in chronic otitis media active mucosal disease (Wet Ear) versus chronic otitis media inactive mucosal disease (dry ear). Indian J Otolaryngol Head Neck Surg 2017; 69 (04) 500-503
  • 17 Konishi M, Sivalingam S, Shin S-H, Vitullo F, Falcioni M. Effects of early commercial air travel on graft healing rates after tympanoplasty. Ann Otol Rhinol Laryngol 2012; 121 (02) 110-112
  • 18 Kouhi A, Khorsandi Ashthiani MT, Jalali MM. Results of type I tympanoplasty using fascia with or without cartilage reinforcement: 10 years’ experience. Iran J Otorhinolaryngol 2018; 30 (97) 103-106
  • 19 Thornton D, Martin TPC, Amin P, Haque S, Wilson S, Smith MCF. Chronic suppurative otitis media in Nepal: ethnicity does not determine whether disease is associated with cholesteatoma or not. J Laryngol Otol 2011; 125 (01) 22-26