Introduction: Chronic otitis media (COM) is now synonymous with chronic suppurative otitis media, which is not actively used since COM is seldom associated with “the collection of pus.” Acute suppuration of the ear which transcends 6 weeks is considered to be COM which suggests an abnormality of the ear drum. With a prevalence incidence of 1%, Eustachian tube (ET) dysfunction is among the most important factors in the development of COM. Recently, mastoid air cells have been acknowledged as an essential compounding factor for the pathogenesis of middle ear disease. Since ET, mastoid air cell system, and nasopharyngeal mass like adenoids can play a pivotal role in the causation and persistence of COM, the current study will be taken to observe the status of ET, mastoid air cells system, nasopharynx in general, and adenoids in particular in patients of COM. Aim: This study aims to study the status of the mastoid antrum on surgical exploration, the status of ET, and nasopharynx for adenoids in patients of large, subtotal perforation, and posterosuperior retraction pockets (PSRPs). Study Design: This study was an observational, cross-sectional study. Study Setting: All the patients with large, subtotal perforation, and PSRPs visiting the Outpatient Department and Inpatient Department of ENT in Acharya Vinoba Bhave Rural Hospital (AVBRH) between 2022 and 2023 will be studied. Methods: All the selected patients of large, subtotal perforation, and posterosuperior retraction pocket (PSRP) in the age bracket of 15–65 years and satisfying the inclusion criteria will be considered and accrued in this study. We plan to look at a sample size of 50 patients (50 ears). Diagnostic nasal video endoscopy to get insight into ET function, size, and grade of adenoids by grading system given by Cassano et al. and pure-tone audiometry by ALPS AD2000 to know the type and amount of hearing loss will be carried out. Status of the mastoid antrum, the extent of the disease, status of ossicles, and associated abnormalities of temporal bone along with any other incidental findings will be noted intraoperatively. Expected Results: The data will be tabulated, analyzed statistically, and will be discussed in the context of existing research. Conclusion: The purpose of the present study is to help the surgeon have a better insight into the status of the mastoid antrum, ET in cases of large and subtotal perforation, and PSRP and nasopharynx in general with significance to adenoids in patients of COM in rural area.
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