Submit Manuscript | http://medcraveonline.com Introduction Chronic otitis media 1 The diagnosis of chronic otitis media (COM) implies a permanent abnormality of the pars tensa or faccida, most likely a result of earlier acute otitis media, negative middle ear pressure or otitis media with efusion. COM equates with the classic term chronic ‘suppurative’ otitis media (CSOM) that is no longer advocated as COM is not necessarily a result of ‘the gathering of pus’. However, the distinction remains between active COM, where there is infammation and the production of pus, and inactive COM, where this is not the case though there is the potential for the ear to become active at some time. A third clinical entity is healed COM where there are permanent abnormalities of the pars tensa, but the ear does not have the propensity to become active because the pars tensa is intact and there are no signifcant retractions of the pars tensa or faccida. ‘Healed COM’ can also be the end result of successful surgery. A. The diferences are summarized in (Table 1). B. It is widely believed that COM often starts with episodes of acute otitis media (AOM) or otitis media with efusion (OME) in childhood. OME may lead to thinning of the tympanic membrane, hearing loss and delayed speech development, and it can impact on the child’s educational development. C. COM can be characterized histopathologically by middle ear pathology such as granulation tissue, cholesterol granulomas or cholesteatoma formation. Active COM is chronic infammation of the middle ear and mastoid mucosa, with recurrent discharge (at least 2 weeks) through a chronic perforation of the tympanic membrane. J Otolaryngol ENT Res. 2020;12(1):37‒44. 37 ©2020 Yaseen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Evaluation of graft taking and hearing threshold after tympanoplasty Volume 12 Issue 1 - 2020 Ehab Taha Yaseen, 1 Ali Mohamed Abdul Qader, 2 Adnan Qahtan Khalaf, 3 Ali Zeno Thanoon 4 1 Head of Department of Surgery, Mustansiriyah University, Iraq 2 AL Yarmouk Teaching Hospital , D.MA. ST (High Diploma in Medical Audiology & Speech Therapy , Iraq 3 Al-Yarmouk Teaching Hospital, Iraq 4 Al-Jamhory Teaching Hospital, ENT Senior House offcer, Iraq Correspondence: Adnan Qahtan Khalaf, AL Yarmouk Teaching Hospital, ENT Specialist, Laser Surgeon Otolaryngologist, Iraq, Tel 009647901783546, Email Received: January 13, 2020 | Published: February 18, 2020 Abstract Background: Tympanoplasty is one of the surgical procedures mainly aimed to restoring the hearing loss and eradication of chronic middle ear diseases. Aim: To evaluate the hearing threshold preoperatively and postoperatively in patients who were subjected to tympanoplasty procedures. Patients and methods: This prospective study included 27 patients attended ENT department of AL-Yarmouk Teaching Hospital ,from February -2017 to October- 2018 , The age of patients between (10-60 years) of both gender . they presented with hearing loss as a result of chronic suppurative otitis media. After full assessment and proper preparation , They underwent Tympanoplasty procedure through post auricular incision using underlay temporalis fascia graft , The type of Tympanoplasty procedure was planned according to the status of the middle ear and ossicular chain .To eradicate disease from both the mastoid and middle ear cavity procedure and could be combined with mastoidectomy, Patients were evaluated preoperatively and followed up for 6 months postoperatively, pure Tone Audiogram was done to asses the change in hearing. Results: The study included 27 patients, (74.06%) of them were the age group between (21–40) years , the least number of patients were younger than 21 years and older than 51 years , 16 females (59.3%) and 11 males (40.7%) , Patients were classifed according to tympanoplasty procedures into fve groups : (Group1):10 patients (37.03%) underwent only Type I tympanoplasty. (Group2): 11 patients (40.7%) Type I with Cortical Mastoidectomy. (Group3): 2 patients (7.4%) Type II with Cortical Mastoidectomy. (Group4): 3 patients (11.1%) Type III with Cortical Mastoidectomy (Group5): one patient (3.7%) Type III with Modifed Radical Mastoidectomy. They had a mean Air-Bone gap improvements were (9.66 dB), (17.4 dB), (13.2 dB), (9.60 dB) and (5.54 dB) respectively. The overall graft success rate was (92.5%). Conclusion: Signifcant improvement was noted in the subjective symptom of hearing loss following the tympanoplasty procedures. The mean Air-Bone gap closure was greatest for type I with cortical mastoidectomy; followed by type II with Cortical Mastoidectomy, type I alone and then type III with Cortical Mastoidectomy. Modifed radical mastoidectomy was associated with the least hearing improvement as otherwise. Journal of Otolaryngology-ENT Research Forum Article Open Access