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Background:The etiopathogenesis of COM is multifactorial, which includes Eustachian tube dysfunction (mechanical obstruction or functional),the mastoid air cell system and other factors like KornerSeptum(because of the attic blockage). Only few studies have been done related to the ethiopathogenesis of squamous type of otitis media.Atticoantraldisease ,the old terminology were used in most of the studies related to COM. Now the terminology has changed with inclusion of inactive squamous type in atticoantral disease. Hence this study focuses to determine the preventable cause of squamous COM and also help in preventing the recurrence of the disease .By addressing the etiopathogenesis ,it also gives better surgical outcome.