• Muhamed Masalha, Lev Shlizerman, Salim Mazzawi, Ophir Handzel, Firas Kassem, Daniel Briscoe, and Kfir Siag.
• Department of Otolaryngology Head and Neck Surgery, Emek Medical Center, Afula, Israel, Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel.
• Isr Med Assoc J. 2023 Jan 1; 25 (1): 424642-46.

BackgroundChronic suppurative otitis media is a long-standing middle ear infection with a perforated tympanic membrane. Tympanoplasty is the mainstay of treatment. Most surgeons prefer to operate on dry ears; however, this may be difficult to achieve.ObjectivesTo investigate the effect of otorrhea and positive cultures on the outcome of tympanoplasty.MethodsThis retrospective analysis reviewed patients with chronic suppurative otitis media who underwent tympanoplasty 2008-2015. Patients were divided into three groups: active discharge and bacterial growth, active discharge without bacterial growth, and no ear discharge. Surgical outcomes were compared among the groups.ResultsAmong 101 patients included, 43 ears (42.6%) had discharge preoperatively, 58 (57.4%) were dry. Overall closure rate was 81.2% (82/101). Preoperative active discharge closure rate was 88.3% (38/43) and without discharge 75.9% (44/58). There were 38 positive cultures preoperatively and five negative cultures. Cultures were not obtained in 58 cases. Success rates were 89.5%, 80%, and 75.9%, respectively. No significant difference was found between patients who had positive or negative cultures before the procedure (P > 0.48) or among the three groups (P = 0.25). The most common bacteria were Pseudomonas aeruginosa (n=17), followed by Staphylococcus species (n=10). None was significantly associated with operative failure (P = 0.557). The postoperative air threshold difference was not affected by culture results (P = 0.3).ConclusionsTympanoplasty success rates and postoperative air threshold differences were not affected by the presence of preoperative otorrhea or positive ear cultures. Surgery can be performed even when the ear is not dry.

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