title: Usefulness of cortical mastoidectomy in myringoplasty.
abstract: OBJECTIVE
  The usefulness of cortical mastoidectomy in myringoplasty remains an issue of controversy. We aimed to assess the effectiveness of mastoidectomy on outcomes of tympanoplasty performed in patients with persistent or intermittent discharging chronic suppurative otitis media without cholesteatoma.
  
  
  METHODS
  Prospective, randomized, single-blinded study. Level of evidence-1B.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Three hundred twenty consecutive adult patients presenting persistent or intermittent otorrhea during the preceding 6 months scheduled for myringoplasty were included.
  
  
  METHODS
  Patients were randomly assigned to undergo either myringoplasty with cortical mastoidectomy (Group A) or myringoplasty only (Group B).
  
  
  METHODS
  Graft success rate and mean postoperative air-bone gap. Auditory outcomes were evaluated at one year postoperatively.
  
  
  RESULTS
  At the end of the follow-up period, there were 24 failures within Group A (success rate, 82.8%) and 34 within Group B (success rate, 76%), statistically not significant. In the univariate analysis, 3 factors were found to be significant in predicting success rate: healthy opposite ear, a long dry period preceding the operation and nonsmoker status. The only factor attaining significance in the multivariate analysis was a dry period longer than 3 months.
  
  
  CONCLUSIONS
  Cortical mastoidectomy offers no additional benefit in myringoplasty performed on patients with persistent or intermittent discharging CSOM and no evidence of cholesteatoma or mucosal blockage within the antrum.
authors.affiliation: II-nd Department of Otolaryngology, University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania. silviualbu63@gmail.com
authors.forename: Silviu
authors.initials: S
authors.lastname: Albu
authors.forename: Franco
authors.initials: F
authors.lastname: Trabalzini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Amadori
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D015999:Multivariate Analysis; D009225:Myringoplasty; D010035:Otitis Media, Suppurative / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D014433:Tympanoplasty; D055815:Young Adult