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Background: Reconstruction of the ossicular chain is performed in 70-90% of tympanoplastic interventions. A cholesteatoma in chronic suppurative otitis media is diagnosed in 24-63% cases, irrespective of localization of the eardrum perforation. Persistently good outcomes after radical mastoidectomy is obtained only in 65 to 66% of patients, and the proportion of unsatisfactory results remains to be rather high (10 to 15%). Aim: To analyze the effectiveness of surgical treatment of patients with chronic suppurative otitis media, operated in a single clinical center from 2014 to 2016. Materials and methods: A total of 212 patients (233 ears) with chronic suppurative otitis media patients, who underwent surgery, were included in this study. The effectiveness of surgical interventions were assessed as short-term (up to 3 months post-operatively) and long-term (6 to 12 months) anatomical and functional outcomes. The anatomical results were considered satisfactory if there was a well-formed mobile neotympanic membrane, air tympanic cavity and dry postoperative cavity. Pure tone audiograms were analyzed to evaluate the functional results. Results: Satisfactory anatomical results were obtained in 93.5% of patients with the safe type suppurative otitis, 88.9% of patients with the unsafe type and 91.2% of patients after a revision surgery. Displacement of total ossicular prosthe-ses was the main cause of poor functional results. The most common causes of unsatisfactory anatomical results were perforation (14 cases), cholesteatoma recurrence (2 cases) and lateralization of the neotympanic membrane (2 cases). Discussion and conclusion: Formation of a reliable sound conducting system with ossicular prostheses allows for persistent improvement of hearing. Various surgical techniques, such as extended posterior tympanotomy, endoscopic assistance, provide a good effect with the removal of non-aggressive cholesteatoma while preserving the bone structures, which are not involved in the disease. A complete removal of an advanced aggressive cholesteatoma with the opening of the temporal bone cell system ensures good functional and anatomical outcomes, makes it possible to prevent the spread of the pathological process and development of intracranial complications.

MANAGEMENT AND SURGICAL OUTCOMES IN PATIENTS WITH CHRONIC SUPPURATIVE OTITIS MEDIA