Outcome of surgery for chronic suppurative otitis media with resistant Pseudomonas aeruginosa

Objective: To assess the effectiveness of surgical treatment of active chronic suppurative otitis media (CSOM) with ciprofloxacin-resistant Pseudomonas aeruginosa (P. aeruginosa) that failed comprehensive local and systemic treatment. Study design: Retrospective case review. Setting: Tertiary referral center. Patients: Eleven patients with ciprofloxacin-resistant P. aeruginosa CSOM that remained active despite comprehensive local and systemic treatment. All patients were operated by a single surgeon between February 2016 and July 2019 Intervention(s): Tympanoplasty alone was performed in seven cases and accompanied by mastoidectomy in the other four cases. Main outcome measure(s): Resolution of infection and tympanic graft take on otoscopy. The secondary outcome measure is hearing. Results: Tympanic graft take was successful and the infectious process was resolved in 8 out of the 11 cases, yielding a success rate of 73%. The average follow-up was 20 months. No surgical complications occurred. Conclusions: Tympanoplasty, with or without mastoidectomy, is safe and yields acceptable anatomical and functional success rates when intensive local and systemic treatment fails to stop the purulent discharge.