Abstract
To study the clinical presentations of chronic suppurative otitis media (CSOM) with cholesteatoma and its complication, 96 patients with CSOM from ENT department of a medical college hospital during January 2011 to January 2014 were included in this study. The highest number of cases belonged to the age group of 11-20 years (55.2%), and the number of males and females was 67.2% and 32.8%, respectively. Almost all the patients presented with multiple symptoms. The most common symptoms were discharge from ear(s) (100.0%), hearing impairment (83.3%), earache (15.6%), fleshy mass in ear(s), etc. Of the patients, 67.9% cases were without complication, 26.1% with extracranial complication and 6.3% with intracranial complication. All the cases had a perforation either in the posterior superior marginal (66.5%) or in the attic region (33.5%). Most of the patients were having unilateral CSOM with cholesteatoma, in the right side (64.3%), left side (35.7%), and a few (4.2%) bilateral involvement. Although 83.3% of the patients complained of deafness, audiometric tests were done in 93.7% of the patients excluding 6.4% who had intracranial complication. All of them (93.7% tested) had developed deafness; mild deafness (20.0%), moderate deafness (77.8%), and severe deafness (2.2%). In conclusion, the pattern of clinical presentation and complication of CSOM with cholesteatoma in rural setting may be similar with the pattern involving urban population and early diagnosis of CSOM with cholesteatoma by taking proper history and clinical examination, and timely surgical intervention may be helpful to eradicate the disease and prevent complications.Mediscope Vol. 4, No. 2: Jul 2017, Page 25-28
Highlights
Chronic suppurative otitis media (CSOM) is a perforated tympanic membrane with persistent drainage from the middle ear.[1,2] Chronic suppuration can occur with or without cholesteatoma, and the clinical history of both conditions can be very similar
Cholesteatoma is a lesion of obscure origin, a slowly progressive and destructive of the middle ear cleft caused by formation of a whitish shiny bag or sac lined by stratified squamous epithelium containing layers of concentric keratin material impregnated with desquamated squamous epithelium with or without cholesterol crystal
67.6% cases were without complication, 26.0% with extracranial complication and 6.4% with intracranial complication
Summary
Chronic suppurative otitis media (CSOM) is a perforated tympanic membrane with persistent drainage from the middle ear (lasting >6-12 weeks).[1,2] Chronic suppuration can occur with or without cholesteatoma, and the clinical history of both conditions can be very similar. Cholesteatoma is a lesion of obscure origin, a slowly progressive and destructive of the middle ear cleft caused by formation of a whitish shiny bag or sac lined by stratified squamous epithelium containing layers of concentric keratin material impregnated with desquamated squamous epithelium with or without cholesterol crystal. It is capable of destroying soft and hard tissues surrounding it producing extracranial and intracranial complications.[3] According to presumed etiology cholesteatoma may be congenital and acquired. The primary acquired cholesteatoma, the most common form of acquired cholesteatoma arises from a skin lined
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