Chronic suppurative otitis media (CSOM) and osteoradionecrosis of the temporal bone are common sequelae of nasopharyngeal carcinoma (NPC) after radiotherapy. Tympanomastoidectomies were carried out for CSOM in 16 patients who had completed radiotherapy for NPC. Eleven (69%) patients had successful tympanoplasty; in eight of them, the otorrhoea was controlled, and the other three patients had persistent otorrhoea due to exposed osteoradionecrotic bone in the external ear canal. Localized osteoradionecrosis of the external ear canal is often associated with CSOM in NPC patients. Adequate removal of necrotic bone is essential in addition to successful tympanoplasty to eliminate otorrhoea. Therefore, we recommended tympanomastoidectomy for NPC patients with active CSOM who fail to respond to conservative treatment.