31 International Journal of Scientific Study | May 2014 | Vol 2 | Issue 2 How Safe is Safe Ear?: A Hospital Based Study S Sandeep 1 , K S Raghavendra 2 , B G Prakash 3 , T Shivaram Shetty 4 1 Assistant Professor, Department of ENT, J.S.S. Medical College, J.S.S. University, Mysore, 2 Junior Consultant, Department of ENT, Narayana Hrudayalaya Hospital, Bangalore, 3 Associate Professor, Department of ENT, J.S.S. Medical College, J.S.S. University, Mysore, 4 Professor, Department of ENT, J.S.S. Medical College, J.S.S. University, Mysore Corresponding Author: Dr. S Sandeep, Door no. 74, Brindavan Extension, 1 st stage, 3 rd Cross, Mysore - 20, Mobile: 9845366551. E-mail: drshetty79@yahoo.co.in type, considered as unsafe ear or dangerous type as it is associated with cholesteatoma and frequently gives rise to intracranial complications. The safe variety of CSOM i.e. CSOM without cholesteatoma can be further classified into active or inactive depending on whether there is infection or not. 3 The present study was undertaken to know the various pathology encountered in tubotympanic type of CSOM i.e. “Safe ear” and to assess how safe is the safe ear? MATERIALS AND METHODS This study has been conducted over a period of 2 years in the Department of ENT JSS Medical College and INTRODUCTION Chronic suppurative otitis media (CSOM) is a long standing infection of a part or whole of the middle ear cleft characterized by ear discharge and a permanent perforation. 1 World health organization defines CSOM as otorrhoea through a perforated tympanic membrane for atleast 2 weeks while others define “chronic” as symptoms persisting for more than 6 weeks. 2 CSOM is classified into the safe (tubotympanic) and unsafe (atticoantral) variety depending on the likelihood of coexisting cholesteatoma. Tubotympanic type which is considered as safe ear as it is less prone to intracranial complications and atticoantral Original Article Abstract Introduction: Chronic suppurative otitis media is one of the commonest ear cases encountered in our outpatient department on day to day basis. Around half of the cases visiting outpatient department are ear problem cases, out of which 52% cases are of ear discharge. Hence this study was undertaken to know the various pathology encountered in chronic suppurative otitis media-tubotympanic type active so called safe ear type and to ensure whether safe ear discharge is really safe or not. Materials and Methods: This study has been conducted in the Department of ENT, JSS Medical College and Hospital, Mysore, Karnataka, India. Study group includes 100 cases of chronic suppurative otitis media-tub tympanic type. Thorough history taking, otoscopic examination, audiometric evaluation, radiological investigation and blood investigations were done. Type of discharge, perforation, associated ear symptom, degree of deafness and otoscopic findings were recorded and patients were subjected to surgery (Cortical mastoidectomy/Tympanoplasty). Intra-operative finding on opening mastoid was taken into account, Otoscopic finding and findings at mastoid exploration compared and analyzed. Results: Safe variety of Chronic Suppurative Otitis Media was common in age group between 21-30 yrs and was more in male population (57%) compared to females. Intraoperative finding showed around 66% cases with granulation in attic, aditus & antrum. Surprisingly 2% cases had cholesteatoma sac and histopathological finding of the specimens taken showed cholesteatoma in 8% of cases. Conclusion: This study suggests that no perforation in Chronic Suppurative Otitis Media is a safe type of perforation. Hence the practice of calling disease as safe or unsafe depending on the site of the disease (tubotympanic or atticoantral) is questionable. Keywords: Central perforation, Cholesteatoma, Chronic Suppurative Otitis Media, Mastoidectomy, Safe ear