Chronic Otitis Media Patients Research Articles

Success rates in restoring hearing loss in patients with chronic otitis media: A systematic review.

ObjectiveTo assess the effectiveness of tympanoplasty in treating chronic otitis media‐related hearing loss, published literature was systematically reviewed to determine the clinical success rate of tympanoplasty at restoring hearing in chronic otitis media patients at a minimum follow‐up period of 12‐months.Data SourcesPubMed, Embase and the Cochrane Library.MethodsTwo independent reviewers performed literature searches. Publications reporting long‐term (≥12‐month) hearing outcomes and complications data on adult and pediatric patients with chronic otitis media were included and assessed for risk of bias and strength of evidence. To assess how tympanoplasty influences long‐term hearing outcomes, data on pure tone audiometry (air‐bone gap) and complications were extracted and synthesized.ResultsThirty‐nine studies met the inclusion criteria. Data from 3162 patients indicated that 14.0% of patients encountered postoperative complications. In adult patients, mean weighted air‐bone gap data show closure from 26.5 dB hearing level (HL) (preoperatively) to 16.1 dB HL (postoperatively). In studies that presented combined adult and pediatric data, the mean preoperative air‐bone gap of 26.7 dB HL was closed to 15.4 dB HL. In 1370 patients with synthesizable data, 70.7% of patients had a postoperative air‐bone gap ˂ 20 dB HL at long‐term follow‐up. Finally, subgroup analysis identified that mean improvement in ABG closure for patients with and without cholesteatoma was 10.0 dB HL and 12.4 dB HL, respectively.ConclusionIn patients with chronic otitis media, tympanoplasty successfully closed the air‐bone gap to within 20 dB HL in 7/10 cases and had an overall complication rate of 14.0%.Level of Evidence2a.

Molecular Characterization of Virulence and Antibiogram profile of Pseudomonas aeruginosa Isolated from Chronic Suppurative Otitis Media Patients, Al-Nasiriyah City, Iraq.

Molecular Characterization of Virulence and Antibiogram profile of Pseudomonas aeruginosa Isolated from Chronic Suppurative Otitis Media Patients, Al-Nasiriyah City, Iraq.

Comparison of two disease\u2011specific instruments assessing health-related quality of life in patients with chronic otitis media

PurposeEvaluating the current health state in chronic otitis media (COM), audiologic results are complemented by subjective outcomes, such as health-related quality of life (HRQoL). Two disease-specific instruments assessing HRQoL in COM in German-speaking patients exist, i.e., the chronic otitis media outcome test (COMOT-15) and the Zurich chronic middle ear inventory (ZCMEI-21). Since the psychometric properties of these questionnaires in a concurrent application are unknown, the aim of this study was to compare the COMOT-15 and the ZCMEI-21.MethodsHRQoL was assessed in adult COM patients using the COMOT-15 and the ZCMEI-21. Psychometric properties were determined, including response distribution, concurrent validity, internal consistency, correlation to hearing and gender differences.ResultsIn 173 patients (mean age 51.5 years), both questionnaires showed normally distributed scores without strong floor and ceiling effects. The total scores and subscores of both questionnaires exhibited satisfactory internal consistency (Cronbach’s α 0.7–0.9) with the exception of the COMOT-15 hearing subscore (α = 0.94) and the ZCMEI-21 medical resource subscore (α = 0.66). Fair correlations between the air conduction pure-tone average and the total scores were found (COMOT-15: r = 0.36, p < 0.0001; ZCMEI-21: r = 0.34, p < 0.0001).ConclusionIn the first study comparing the COMOT-15 and the ZCMEI-21, both questionnaires exhibited satisfactory psychometric properties with several subtle differences. The COMOT-15 has a strong focus on hearing with a probably redundant content of the hearing subscore and may be suited for hearing-focused research questions. The ZCMEI-21 provides a comprehensive assessment of the COM symptom complex and may therefore also be used in research settings, where ear discharge, vertigo or pain should be covered.

Study of bacteriological profile in chronic suppurative otitis media and their pattern of antibiotic sensitivity

&lt;p class="abstract"&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chronic suppurative otitis media is a long-standing infection of the middle ear cleft which is characterized by recurrent and persistent ear discharge and persistent non healing perforation of tympanic membrane. It can lead to severe complications if not treated appropriately. Due to emerging antibiotic resistance, it is necessary to understand the antimicrobial pattern and their sensitivity to antibiotics which will help clinicians to select antibiotic which is sensitive to their corresponding microorganism. The aim of the study is to isolate the prevalent microorganism and study their antibiotic sensitivity pattern in patients of chronic suppurative otitis media (CSOM).&lt;/p&gt;&lt;p class="abstract"&gt; &lt;strong&gt;Methods:&lt;/strong&gt; Total 100 patients were examined, ear swab were collected by sterile ear swab and sent for microscopy and culture sensitivity examination to microbiology department. Results were documented and analyzed.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results: &lt;/strong&gt;Pseudomonas aeruginosa was the most common isolate (41%) followed by Staphylococci (28.2%). Gram negative cocci showed high degree of sensitivity to Cotrimoxazole (100%), Amikacin (79%) and Piperacillin - tazobactum (75%). Gram positive cocci showed high degree of sensitivity to Linezolid.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Study of bacteriological profile and their sensitivity pattern helps in empirical therapy and reduces the risk of complications.&lt;/p&gt;

Microbiological Assessment of Chronic Otitis Media: Aerobic Culture Isolates and Their Antimicrobial Susceptibility Patterns.

As there are changing trends in the microbiology of chronic otitis media, this study was carried out to look for the current aerobic microbes and their antimicrobial susceptibilities in patients of chronic otitis media from north Indian region. A total of 322 patients who met the inclusion criteria were studied and aerobic ear swab culture was done under aseptic conditions. Gram staining was performed and antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method on Mueller-Hinton Agar. A total of 341 culture positive results were obtained from 322 patients. The culture results revealed 10 different aerobic microbes. Gram-positive floras were seen in 152 (44.57%), and Gram-negative in 189(55.43%) isolates. Staphylococcus aureus was the most common isolate present in 131 samples (38.41%), followed by pseudomonas aeruginosa in 101 (29.62%) and proteus in 36 (10.56%). In overall susceptibility of antibiotics against Gram-positive culture isolates, Vancomycin was most effective (97.37%). For Gram-negative microbes, Piperacillin-Tazobactum combination was most effective with overall susceptibility of 79.37% susceptibility. Microbiological assessment of Chronic Otitis Media should be carried out in an area on regular intervals because of the changing patterns of bacteriology and their antimicrobial susceptibilities.

Use of Glass Ionomer Cement for Incudostapedial Rebridging Ossiculoplasty.

Introduction:The ossicles of the middle ear are affected by the erosive effect of pathology in chronic otitis media. Ossicular reparation can be done via autologous incus or with alloplastic materials. Glass ionomer cement (GIC) is simple to use and saves considerable operative time and expenses especially in developing countries where costly ossicular prosthesis are not affordable for the majority of the patients.Materials and Methods:Twenty-five chronic otitis media patients who underwent surgery were included in this study. The reconstruction material used in this study was glass ionomer cement. All patients had erosion of the long process of incus and a normal stapes. Results: Pure tone average in pre-operative and post-operative period of study patients were 50.09 & 29.92 dB respectively (P=0.01) and the air-bone gap was 24.85 dB preoperatively and 14.05 dB postoperatively. The closure of the air-bone gap was statistically significant (P= 0.01). Conclusion:The study showed that the use of GIC ossiculoplasty is an efficient method for the reparation of the long process of the incus. The results are encouraging and indicate that it is worthwhile to conduct more trials using this method.

Changing microbiological picture and sensitivity in otolaryngology in developing world

&lt;p class="abstract"&gt;&lt;strong&gt;Background: &lt;/strong&gt;Microbiology, culture and sensitivity and antibiotic policy are ever changing in otolaryngology. So, it requires continuous research and modification.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective study was conducted at our tertiary care center where microbiology and culture and sensitivity data of patients of chronic otitis media and neck abscess were assessed to form antibiotic policy for the concerned patients. The study comprised of 580 patients of chronic otitis media and 139 patients of neck abscess admitted from October 2018 to December 2019.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results: &lt;/strong&gt;&lt;em&gt;Pseudomonas&lt;/em&gt; and &lt;em&gt;E. Coli &lt;/em&gt;were the most common microbes isolated with most of cases sensitive to Meropenem and Amikacin respectively.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;There is a change in microbiological picture and sensitivity to a more resistant type than the previous studies and hence the requirement of modification of antibiotic policy to a more robust one.&lt;/p&gt;

An observational study of endoscopic versus microscopic type I tympanoplasty in tubotympanic chronic otitis media in a tertiary health care centre

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Chronic otitis media (COM) is a widespread disease in the developing countries. It is treated by tympanoplasty, traditionally performed with the microscope which limits the visual field in the deep recesses of the middle ear, especially in narrow external auditory canal. Using endoscope has minimised these difficulties by providing a wide field view with angled magnification, reducing the duration of surgery. The advantages and disadvantages of both techniques is evaluated in our study.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; In this observational study, 60 patients of tubotympanic COM between 12-60 years of age with small to medium sized central perforation and air-bone gap of less than 45 decibel were included. They were divided into two groups (group A and group B) of 30 patients each. Group A underwent microscopic type 1 tympanoplasty and group B underwent endoscopic type 1 tympanoplasty. The duration of the surgery, the post-operative improvement in hearing and the graft uptake was analysed after 3 months of surgery. The post-operative hospital stay duration was noted. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The post-operative hearing improvement and the graft uptake after 3 months of the surgery was statistically not significant between the two groups. But the mean duration of the operation and the post-operative hospital stay was significantly lower in the endoscopic group with a p value &amp;lt;0.05.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Endoscopes are better in otological procedures as it reduces the surgical duration, provides better visibility, lessens the post-operative hospital stay, reducing the economic burden of the patient.&lt;/p&gt;

The Romanian Version of Health-Related Quality of Life Questionnaire 12 for Chronic Otitis Media. The Socio-Economic Status Impact Significance

Objective: Our primary objective was to translate and validate Chronic Otitis Media (COM) Questionnaire-12 (COMQ-12) in Romanian. The secondary objective was to investigate the effect of the socioeconomic status on the preoperative COMQ-12 scores in individuals with a similar stage of disease. Methods: This was a cross-sectional study. Patients diagnosed with different stages of (COM) with cholesteatoma, scheduled for the first surgery, filled in the Romanian translated version of the COMQ-12. The patients were divided according to the stage of the disease and the environment of origin: rural versus urban areas. Results: The internal consistency of the Romanian COMQ-12 proved excellent, with a Cronbach’s alpha equal to 0.959. The correlation of the 24 randomly split-half reliability analysis varied from 0.904 to 0.917, with a mean of 0.908. Significantly higher COMQ-12 scores are obtained by patients from urban (mean = 42.14, SD =9.04) as compared to those from rural (mean = 30.44, SD = 5.88) only for those with stage III disease (P-value=0.0292). Conclusions: Romanian version of COMQ-12 proved to be a valid instrument that can be use in clinical practice to provide suitable information in COM patients, which contributes to the development of an international common otology dataset. Patients from rural areas tend to disregard their symptoms, being more predisposed to potential complications related to COM rather than urban patients at the same stage of the disease.

English

BACKGROUND Active mucosal chronic otitis media (COM) is a disease of the middle ear cleft associated with inflammation and production of pus. The incidence is high in developing countries. It affects all age groups and both genders. If not properly treated, it can lead to complications. The bacterial isolates and their sensitivity pattern vary from place to place and also over time. Early identification of the microorganisms and their antibiotic sensitivity patterns helps in proper selection of antibiotics and quick recovery in COM patients. METHODS Fifty patients with active mucosal COM were selected for the study. The study was conducted over a period of one year. Ear swab from the deep external auditory canal was collected under strict aseptic precautions from these patients before starting antibiotic treatment. Microorganisms were identified by gram staining, growth on different agar plates, and various biochemical tests. Antibiotic sensitivity was done by the Kirby-Bauer method. RESULTS Majority of the patients were in the age group of 21 - 40 years (42 %) with female preponderance (62 %). All patients had a central perforation in the tympanic membrane (100 %). Bacterial growth was seen in 44 samples (88 %). Two samples (4 %) showed fungal growth. Four samples (8 %) showed no growth even after 48 hours of incubation. Single bacterium was isolated in 41 cases (82 %) whereas 3 samples (6 %) showed more than one bacterial growth. The predominant bacteria were Pseudomonas aeruginosa (50 %) followed by Staphylococcus aureus. The other isolates were coagulase negative staphylococci, enterococci, enterobacter, acinetobacter, and E coli. Pseudomonas showed maximum sensitivity to amikacin, imipenem and piperacillin / tazobactam (100 %). The most effective antibiotics for staphylococcus was vancomycin and linezolid. CONCLUSIONS The most common bacteria isolated in active mucosal COM were pseudomonas followed by Staphylococcus aureus. The most effective antibiotics for pseudomonas was amikacin, imipenem and piperacillin / tazobactam. Staphylococcus showed maximum sensitivity to vancomycin and linezolid. KEYWORDS Chronic Otitis Media (COM), Active Mucosal, Ear Swab, Bacteriology, Sensitivity

Segmental Facial Nerve Decompression in Patients of Chronic Suppurative Otitis Media with Diabetes Mellitus

Introduction: Facial nerve decompression is opening the bony canal and nerve sheath to release pressure and reduce compression on nerve fibers. The goal of decompression is to improve blood circulation and minimize damage to distal nerve fibers. Methodology: We present study of 20 patients who came to ENT OPD, From June, 2017 –March, 2020 presented to us with non-traumatic facial palsy grade III and above; in whom we did facial nerve decompression via trans-mastoid approach. Conclusion: Segmental decompression of facial nerve with masoidectomy provides better results than mastoidectomy alone because it enables expansion of nerve, reduces post-operative oedema and less need for steroid administration in diabetic patients with better clinical outcome.

Microbiology of Chronic Suppurative Otitis Media: An update from a Tertiary Care Hospital in Bangladesh.

Objectives:Chronic suppurative otitis media is a major cause of acquired hearing impairment, especially in children of developing countries. The study sought to explore the bacteriological profile and their antimicrobial susceptibility among patients of chronic suppurative otitis media from a tertiary care hospital in Bangladesh.Methods:A cross sectional microbiological study was conducted at the Department of Microbiology, Rajshahi Medical College, Bangladesh from January to December 2019. Aural swabs were collected aseptically from clinically suspected patients irrespective of age and gender attending the ear, nose and throat outpatient department of Rajshahi Medical College Hospital. Aerobic bacterial culture was done and isolates were identified through standard bacteriological identification scheme. Antimicrobial susceptibility testing of isolates was done by modified Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines.Results:Of 96 swabs, culture yielded a total of 73 bacterial isolates from 68(70.8%) culture-positive plates including 63 (65.6%) unimicrobial and 5 (5.2%) polymicrobial (mixed growth of a pair of bacteria) growths. Frequency distribution revealed, 40(55%) gram-negative and 33(45%) gram-positive bacteria with Staphylococcus aureus was the leading isolate (37%) followed by Pseudomonas aeruginosa (31.5%), Escherichia coli (13.7%), coagulase-negative Staphylococcus (8.2%), Klebsiella pneumoniae (5.5%) and Proteus spp. (4.1%). Gram-positive bacteria were found to be highly susceptible (100%) to Linezolid and Vancomycin followed by Imipenem (83 to 96.3%), while moderate to high resistance (44 to 67%) was observed against Ciprofloxacin, Ceftriaxone, Ceftazidime, Amoxicillin/Clavulanate and Clindamycin. For gram-negative bacteria, susceptibility ranged from 67 to 100% to Imipenem, 67 to 96% to Piperacillin/Tazobactam and 67 to 83% to Gentamicin, while moderate to high resistance (50 to 75%) was observed against Ciprofloxacin, Ceftriaxone, Ceftazidime and Amoxicillin/Clavulanate.Conclusion:Moderate to high level of multidrug-resistance especially to 3rd generation cephalosporins, Ciprofloxacin and Amoxicillin/Clavulanate is an alarming situation. It warns reinforcement of judicious antibiotic prescription and introduction of antibiotic stewardship program in the tertiary care hospitals.

Serum Immunoglobulin E and Serotonin levels in Chronic Supporative Otitis Media Patients with and without treatment.

Objective:To determine the serum immunoglobulin E and serotonin levels of patients with chronic suppurative otitis media (CSOM) with and without treatment.Methods:This is a case-control study carried out in ENT ward of Jinnah Postgraduate Medical Centre Karachi Pakistan from May to September 2018.. Sample (n=160) was divided into four groups (40 individuals per group) as G1: control negative (group-1 without any disease), G2: positive control (patients didn’t received medicines), G3: group (patients treated with co-amoxicillin 1000mg per day) and G4: group (patients treated with ciprofloxacin1000mg per day). After treatment period of One week serum immunoglobulin E and serotonin concentrations were evaluated by Elisa method at 450nm.Statistical evaluation was carried out using one-way ANOVA (p<0.05) followed by post hoc (tukey test) for further group comparison. In order to find out correlation between IgE and serotonin with CSOM Pearson’s correlation was applied.Results:There was no significant (p > 0.05) association found between genders with serotonin as well as with IgE levels in CSOM patients. One way ANOVA showed significant difference (p<0.05) for IgE and serotonin levels and post hoc (tukey test) showed significant higher of IgE levels in CSOM patients of G2 positive control (diseased patients) was observed when compared to the control negative group (healthy individuals) and also from treated groups of G3 and G4. This also showed that serotonin levels were significantly low in G2 (positive control) as well as in treated groups of G3 and G4 in contrast with healthy individuals of group G1.Conclusion:Antibiotics may revert the higher levels of IgE but cannot attenuate the decreased levels of neurotransmitter (serotonin) like healthy individuals, therefore, depression levels of CSOM patients should be monitored, scored and attenuated with proper intervention of antidepressants or counseling.

Association of Ki-67 Level on Bone Destruction in Chronic Suppurative Otitis Media Patients with Cholesteatoma

Background: Chronic suppurative otitis media (CSOM) with cholesteatoma is one of the most common chronic infections found in developing countries. Cholesteatoma will stimulate bone resorption from the epithelial and stromal cells resulting in cytokine and keratinocyte formation, as well as mastoid bone destruction. The Ki-67 found in the proliferating cell shows that this protein plays an important role as a cell division process marker. Objective: Analyzing the association of Ki-67 on bone destruction in CSOM with cholesteatoma. Method: Participants in this study were CSOM patients with cholesteatoma who underwent surgery. Participants were assessed for bone destruction based on CT scan examination and confirmed during surgery. Examination of Ki-67 levels was carried out by taking cholesteatoma tissue at the time of surgery and analyzed using the ELISA method. The results of the examination were analyzed using the Spearman's rank correlation, Pearson’s correlation and logistic regression with p < 0.05. Results: The value of Ki-67 levels at each degree of destruction was degree 1 of 0.301, degree 2 of 0.36 ± 0.34, degree 3 of 0.41 ± 0.07, degree 4 of 0.60 ± 0.85, degree 5 of 0.74 ± 0.12, and degree 6 equal to 0.90 (r = 0.906; p = 0.001). In addition, there was a significant relationship between symptoms duration on bone destruction (r = 0.913; p = 0.001) and levels of Ki-67 (r = 0.887; p < 0.001). The regression coefficient was 0.079 for the independent variable, bone destruction with p = 0.009, and the regression coefficient 0.024 for symptoms duration with p = 0.014. Conclusion: Increased Ki-67 level in cholesteatoma is associated with bone destruction degree in CSOM patients with cholesteatoma.

Associated factors, health-related quality of life, and reported costs of chronic otitis media in adults at two otologic referral centers in a middle-income country.

Despite the high prevalence of chronic otitis media (COM) in low to middle-income countries, there are few studies regarding its associated factors, health-related quality of life, and treatment costs. This study aimed to identify associated factors of COM, assess its impact on the quality of life as well as estimate the patients' reported costs of COM treatment in Colombia. Cross-sectional study. Two otology-referral centers in Bogotá (Colombia) were included. Questionnaires focusing on sociodemographic and clinical associated factors, quality of life, and patients' reported costs were administered to 200 adults with COM diagnosis and 144 control adults. Otoscopic evaluation and audiometric data were collected. The mean age was 42.2 years (SD: 14.44). The median length of COM was 26.13 years (SD: 17.06), and 79.5% of the COM patients reported otorrhea during childhood (P-value: 0.01). The most frequently reported allergic disease among our study population was allergic rhinitis (26.5%). COM was less frequent in patients with a medium-high socioeconomic status (PR: 0.54; 95% CI: 0.39-0.72), and more frequent in patients who reported increased ear discharge due to upper respiratory tract infections (PR: 1.69; 95% CI: 1.68-1.70). The global score of the "Chronic Suppurative Otitis Media Questionnaire-12" showed a difference of 9 points between patients with active and inactive COM (P < 0.001). Patients spent between 12.07% to 60.37% of their household income on expenses related to COM. Associated factors found in this study are consistent with previous reports. COM has a significant financial impact and affects patients' quality of life. Worldwide research addressing these issues in poor-resource countries is scarce, further studies are needed.

Outcome of underlay versus interlay tympanoplasty in patients with inactive mucosal chronic otitis media with large central perforation: a retrospective comparative study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Aim and objective were to study the outcome of underlay versus interlay tympanoplasty in patients with inactive mucosal chronic otitis media with large central perforations in terms of graft uptake rate and hearing improvement. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The present study was conducted retrospectively on 110 patients of inactive mucosal chronic otitis media with large central perforation, 55 patients selected from each group undergoing underlay or interlay technique in a tertiary referral hospital, Department of ENT, ESIC Kalaburagi, Karnataka, from February 1 2018 to January 31, 2020. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Total 110 patients were included in the study. Male:female ratio was 1:2.2. The age group in this study ranged from 13-50 years of age. Preoperative mean air bone gap in groups A and B was 30.28±6.62, and 30.18±6.87 dB and postoperative mean air bone gap was 19.44±7.66 and 15.13±6.3 dB. In both the groups a significant mean reduction in air bone gap was observed. Mean reduction was maximum in group B. Statistically, intergroup difference in reduction in air bone gap was highly significant (p&amp;lt;0.001). Graft success rate being 89.09% and 94.54% in underlay (group A) and interlay (group B) respectively.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Interlay is a better technique than underlay in chronic otitis media inactive mucosal disease with large central perforation in terms of hearing improvement and graft uptake. &lt;/p&gt;

A novel Turkish instrument for assessing quality of life in chronic otitis media –translation and validation of Zurich chronic middle ear inventory

Background/aimThe Zurich Chronic Middle Ear Questionnaire (ZCMEI-21) is a newly-developed German-language questionnaire. The purpose of this study was to analyze the quality of life (QoL) of chronic otitis media (COM) patients and translate, transculturally adapt, and validate the ZCMEI-21 into Turkish.Materials and methodsBased on internationally accepted guidelines, the ZCMEI-21 was translated into Turkish. To assess its validity, the total score of the ZCMEI-21-Tur was compared to the scores taken from the original validation study and a question that was directly related to the health-related QoL (HRQoL), as well as the general criterion EQ-5D-5L. Questionnaires were completed by healthy volunteers and the results were evaluated statistically.ResultsA total of 80 COM patients and 40 healthy volunteers were prospectively enrolled in this study. Regarding internal consistency, the questionnaire showed a Cronbach α of 0.94, which indicated high internal consistency. Moreover, internal consistency was also determined to be excellent for the Cronbach α of the individual subscales, as follows: ear sign symptoms, 0.79; hearing, 0.83; psychosocial impact, 0.91, and medical resources, 0.84.ConclusionsThe ZCMEI-21 was translated into Turkish and validated. Therefore, the ZCMEI-21-Tur was suitable for use in assessing HRQoL in adult patients with COM.

Clinico-microbial profile of Otomycosis in discharging otitis media in tertiary care hospital

Introduction: Discharging otitis media with superadded fungal infection is now become major otolarynological problems in India commonly seen in children and also in adults. The incidence has been increased in proportion to the wide spread use of topical antibiotics aural preparations. Materials and Methods: Total 176 patients belonging to all age groups and both sexes(128 – male and 48 – female) were included. All were prediagnosed cases of discharging otitis media enrolled in the study. Results:Out of 176 cases, 106 cases (76-male, 30-female) belong to acute suppurative otitis media (ASOM) and 70 cases (52-male, 18-female) belong to chronic suppurative otitis media (CSOM). In mycological profile of both type of otitis media acute and chronic, 10 fungus isolated, 9 isolates were in chronic suppurative otitis media, of which 6 were of Aspergillus species and remaining 3 were belong to Candida isolates. Only one isolates of Candida albicans was seen in acute suppurative otitis media. Conclusion:We found that majority of the patients of chronic suppurative otitis media with superadded fungal infection as compared to acute suppurative otitis media. Keywords:Acute suppurative otitis media(ASOM), chronic suppurative otitis media(CSOM), mycological profile

Microbiological profile and changing trends of antibiogram profile in patients of chronic suppurative otitis media in a tertiary hospital in NCR region

Introduction: Otitis media (OM) is a major health issue involving mainly middle ear and is quite prevalent in developing countries in the low socioeconomic group. The aim of this study was to isolate the organisms associated with chronic suppurative otitis media (CSOM) and to detect the antibiogram of the aerobic isolates. Methods: A total of 150 patients clinically diagnosed with CSOM were enrolled in the study and the samples were obtained from each patient using sterile cotton swabs and cultured for microbial flora. Drug susceptibility testing for aerobic isolates was conducted using Kirby-Bauer disc diffusion method. Results: Out of the 119 (79.33%) were culture positive, of which 93 (78.15%) were pure bacterial isolates and 26 (27.95%) were mixed cultures. Bacterial isolates in pure cultures were Staphylococcus aureus in 46 isolates (49.46%), Pseudomonas aeruginosa 22(23.6%). Antimicrobial profile of aerobic isolates revealed maximum sensitivity to amikacin (95.5%), ceftriaxone (83.4%) and gentamicin (82.7%). Conclusions: Knowing the etiological agents of CSOM and their antimicrobial susceptibility is of essential importance for an effective treatment, prevention of both complications and development of antibiotic resistance and finally, the reduction of the treatment costs. Keywords: Attico-antral, Chronic suppurative otitis media, Pseudomonas aeruginosa, Staphylococcus aureus.

Bacteriological profile and drug sensitivity patterns in chronic suppurative otitis media patients at J. L. N. Hospital &amp; Research Centre, Bhilai, Chhattisgarh State, India

Objective: To isolate and identify various bacterial pathogens in positive ear swab cultures of CSOM cases and to determine the antibiotic sensitivity pattern of different bacterial species identified. Study design: Prospective study Setting: J. L. N. Hospital & Research Centre, Bhilai (C.G). Materials and Method: The study was done on the population of Bhilai and surrounding region. A sample size of 120 cases attending the ENT OPD with the diagnosis of Chronic Suppurative Otitis Media and active ear discharge were included in the study. Detailed history, general physical examination, local systemic examination was done along with aural swab for Gram’s staining and aerobic bacterial culture and drug sensitivity . The data were then compared with the relevant & available literature. Results: Most of the patients were in the age group of 11-20 years (38.33%), followed by 21-30 years age group (31.67%). More males (60%) were affected by the disease than females (40%). Unilateral (59.16%) infection was more common than bilateral (40.83%). Incidence of monobacterial (90%) etiology was more common than polymicrobial (9.1%). Staphylococcus aureus 67 (51.53%) was the most commonly isolated bacteria followed by the Pseudomonas 26 (20%). Antibiogram showed the most effective drugs in the present study are clindamycin, cotrimoxazole, ciprofloxacin, amikacin, chloramphenicol and ceftazidime Conclusion: Staphylococcus aureus is the most common pathogen isolated, followed by Pseudomonas. Clindamycin was the most effective antibiotic followed by cotrimoxazole, ciprofloxacin, amikacin, chloramphenicol and ceftazidime. Antibiotic sensitivity of the organisms varies according to geographical area and local practice regarding the choice of antibiotics. A continuous and periodic evaluation of microbiological pattern and their antibiotic sensitivity pattern in local area is helpful in prescribing empirical antibiotics for successful treatment of otitis media and thus minimi