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    Chronic suppurative otitis media (CSOM) is defined as a permanent perforation of the tympanic membrane with persistent discharge from the middle ear, lasting more than 6-12 weeks. (Phub T et al., 2012). Chronic suppuration can occur with or without cholesteatoma, and the clinical history of both conditions can be very similar. The treatment plan for cholesteatoma always includes tympanomastoid surgery with medical treatment as an adjunct. (Wright D& Safranek S., 2009). Tympanic membrane perforation (TMP) is a common otologic problem leading to conductive hearing loss. (Amoils CP et al ., 1992 ). A persistent TMP increases the patient risk of developing recurrent acute otitis media or chronic middle ear disease, These conditions are frequently associated with an unpleasant otorrhea, The myringoplasty is a surgical procedure that closes a simple perforated tympanic membrane . (Sckolnick JS et al., 2008).

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