ABSTRACT
To assess the intraoperative findings during canal wall down mastoidectomy in patients for unsafe type of chronic suppurative otitis media [CSOM]. This prospective interventional study was carried out at Department of ENT and Pediatrics of Ghulam Muhammad Mahar Medical College Hospital, Sukkur, Pakistan from June 2009 to June 2011. Eighty patients who were 5-55 years of age, of both genders, with CSOM who underwent canal wall down mastoidectomy were included in the study. The operative findings like extent of cholesteatoma, granulation tissue in different location in middle ear cleft and ossicular chain condition and otogenic complication were identified. Females were affected more than males [n=48; 60%]. Granulation tissue was found in 50 [62.5%] of cases, while cholesteatoma in 30 [37.5%] cases. The extent of disease was attic in 4 [5%], attic and middle ear 30 [37.5%], attic and antrum 16 [20%] and attic, antrum and middle ear 30 [37%] patients. In majority of the cases there were involvement of more than one ossicle; among the most affected single ossicle malleus was found necrosed in 50 [62.5%], and absent in 6 [7.5%] cases, incus was found necrosed in 42 [52.5%], and stapes was found necrosed in 20 [25%] of cases. The primary disease found in our patients undergoing canal wall down mastoidectomy was granulation. Less common were cholesteatoma and multi-ossicular