POPULATION-BASED OUTCOMES OF INTACT CANAL WALL MASTOIDECTOMY FOR CHRONIC SUPPURATIVE OTITIS MEDIA WITH INTACT OSSICULAR CHAIN: FUNCTIONAL AND AUDIOLOGICAL DETERMINANTS IN RELATION TO DEMOGRAPHIC AND SOCIOECONOMIC VARIABLES

Abstract

Background: suppurative otitis media (CSOM), including tubotympanic disease and limited cholesteatoma confined to the antrum and aditus with an intact ossicular chain, remains a major cause of preventable hearing impairment, particularly in socioeconomically disadvantaged populations. Intact canal wall (ICW) procedures aim to eradicate disease while preserving middle ear anatomy and functional hearing. Intact canal wall (ICW) mastoidectomy with tympanoplasty is widely performed for CSOM with intact ossicular chain aimed at disease eradication and hearing preservation. This study evaluates demographic (age, gender), socioeconomic (education, economic status), clinical (time to surgical intervention, hospital stay), audiological (PTA, ABG, impedance), complications, interaural attenuation, and functional subjective acceptance of residual hearing. Methods: A population-based cohort of CSOM patients undergoing ICW surgery between October 2023 and September 2025 was analyzed. Variables collected included socio-demographics, duration from symptom onset to surgery, pre- and postoperative PTA, ABG, impedance audiometry, complications, interaural attenuation, and subjective hearing acceptance. Statistical analyses explored associations of outcomes with demographic and socioeconomic factors.

Results: Of the 87 patients included, significant improvements were noted in mean PTA thresholds and ABG (pre vs post, p < 0.05). Impedance findings improved postoperatively in 76/87 patients [87.35%]. Early surgical intervention and higher education status were associated with better functional outcomes (p < 0.01). Complication rates were low. Subjective acceptance correlated with objective audiological gains.

Conclusion: This population-based study confirms that intact canal wall (ICW) mastoidectomy with tympanoplasty is a safe and effective surgical option for selected cases of chronic suppurative otitis media with an intact ossicular chain. Significant postoperative audiological improvement was demonstrated, with mean pure tone average improving from 38.45 ± 3.15 dB to 22.65 ± 2.30 dB and air–bone gap reducing from 26.45 ± 3.50 dB to 10.18 ± 1.15 dB (p < 0.05). Improved middle ear compliance was observed in 87.35% of patients, while interaural attenuation improved in 65.52%.