Association of the Laterality of Chronic Suppurative Otitis Media with the Laterality of Sinonasal Disease Based on Temporal Bone CT - Scan Results and Lund Mackay Scoring System

Abstract

Objective: To determine the association between the laterality of chronic suppurative otitis media (CSOM) and the laterality of sinonasal disease, based on temporal bone ct-scan results and Lund-Mackay Scoring system, among patients admitted for ear surgery in a tertiary government hospital in Metro Manila.
 Method:
 Design: Retrospective review of records
 Setting: Tertiary Government Hospital
 Patients: Ninety-eight patients diagnosed with chronic suppurative otitis media admitted for otologic surgery in the Department of Otorhinolaryngology – Head and Neck Surgery from January 2011 to June 2014 were considered for inclusion. Hospital charts and temporal bone ct-scan results were retrieved and analyzed for ear and sinonasal radiographic abnormalities and laterality. Excluded were those without CT-scan plates, who underwent temporal bone surgery for reasons other than chronic suppurative otitis media, and those with incomplete records. The Lund-Mackay Scoring System was used to grade sinonasal findings which were compared to CSOM complications. Data was analyzed using t-test, ANOVA for homogenous numerical data, Kruskal-Wallis for heterogenous numerical data, and chi-square test for nominal type of data. 
 Results: Of the 64 patients included in the study, 12 or 18.75% had radiographic sinonasal abnormalities. There was no significant association between the laterality of ear disease and the laterality of sinonasal pathology as there was no significant difference in the proportion of subjects with sinonasal disease according to laterality of CSOM (p=.32). When site of nose pathology was compared to Lund-Mackay graded scores, it was found that bilateral nose pathology generally had a higher Lund-Mackay score of 8.60 ± 5.60. However, there was no significant difference in the Lund-Mackay score according to the nose pathology site (p=.20). An association was seen between total LMS and patients with ear pathologies, but no significant difference was noted (p=.44). Although patients with ear complications had higher LM scores, this was not statistically significant.
 Conclusion: Laterality of ear disease was not associated with the laterality of sinonasal disease, although CSOM complications were associated with high Lund-Mackay scores. Future, better-designed studies may shed more light on these associations.
 Keywords: chronic suppurative otitis media, sinonasal disease, Lund-Mackay, Temporal Bone CT-Scan