Incidence Of Chronic Suppurative Otitis Media Research Articles

Characteristics of Poly ENT HN Patients at Umbu Rara Meha Hospital and Physical Examination Features Obtained in Cases of Chronic Suppurative Otitis Media (CSOM) Benign Type and Malignant Type

Introduction: Chronic suppurative otitis media (CSOM) is a chronic infection of the middle ear which has been in the process for more than 2 months, which is characterized by a perforation of the tympanic membrane and continuous or intermittent discharge from the ear canal. In developing countries like Indonesia, the incidence of CSOM is quite high. Objective: to find out the characteristics of patient visits to the ENT polyclinic at Umbu Rara Meha Hospital and to find differences in the results of physical examinations for the Benign/ Benign type CSOM and the Danger/Malignant type of CSOM. Method: The type of research used is observational analytics with a cross sectional design. Results and Discussion: based on the characteristics of patients visiting the ENT HN polyclinic, it was found that the dominant patients visiting the ENT HN polyclinic were male patients 50.7%, the age group 21-30 years 23% and ages 0-10 years 18.4%, most residents in cities who visiting Kambajawa 16.2%, high school education level 34.6%, Christianity 62.5%, using BPJS payments 51.5% and coming from the Sumba tribe 54.4%. The top 3 diseases in the ENT HN field are obturan cerumen 18.36%, rhinosinusitis 13.97% and cases of CSOM 12.2%. Conclusion: CSOM is included in the top three lists of the ten most common diseases at Umbu Rara Meha Hospital, determining the type of CSOM including the Benign or benign type or the malignant or malignant type will determine the appropriate therapeutic action and the prognosis of the patient's disease.

Comparison of Germ Patterns and Antimicrobial Susceptibility in Chronic Suppurative Otitis Media with Cholesteatoma and without Cholesteatoma in Dr. Mohammad Hoesin Hospital.

Introduction: Chronic suppurative otitis media (CSOM) is a chronic inflammation of the middle ear and mastoid cavity. It is necessary to identify bacterial patterns and antibiotics susceptibility in CSOM. Appropriate administration of antibiotics is essential to treat infection and prevent widespread resistance.
 Objective: The aim of this study is to compare the pattern of germs and antibiotic susceptibility between CSOM with cholesteatoma and without cholesteatoma.
 Methods: Observational study with cross-sectional design. Data collection was carried out using medical record data on 102 subjects who underwent middle ear swab and bacterial culture from January to December 2019.
 Results: From 102 subjects and 122 bacterial culture results. it was found that Pseudomonas aeruginosa (36.1%) was one of the most common organisms to cause CSOM. followed by Staphylococcus haemolyticus. Staphylococcus epidermidis and Staphylococcus aureus. There was a significant difference between the germ pattern and the type of CSOM (p = 0.002). Amikacin. meropenem. gentamicin. cefepime. ciprofloxacin and ceftazidime were found to be the most effective antibiotics for Pseudomonas aeruginosa. The rate of resistance to tigecycline and cefazoline were highest. Age. sex. nutritional status and comorbidities were not factors that significantly influenced the incidence of cholesteatoma in CSOM.
 Conclusion: There is a significant difference between the germ pattern in both CSOM groups. Patients that show Gram negative have a significant effect on the incidence of CSOM with cholesteatoma.

Comparison of Germ Patterns and Antimicrobial Susceptibility in Chronic Suppurative Otitis Media with Cholesteatoma and without Cholesteatoma in Dr. Mohammad Hoesin Hospital.

Introduction: Chronic suppurative otitis media (CSOM) is a chronic inflammation of the middle ear and mastoid cavity. It is necessary to identify bacterial patterns and antibiotics susceptibility in CSOM. Appropriate administration of antibiotics is essential to treat infection and prevent widespread resistance.
 Objective: The aim of this study is to compare the pattern of germs and antibiotic susceptibility between CSOM with cholesteatoma and without cholesteatoma.
 Methods: Observational study with cross-sectional design. Data collection was carried out using medical record data on 102 subjects who underwent middle ear swab and bacterial culture from January to December 2019.
 Results: From 102 subjects and 122 bacterial culture results. it was found that Pseudomonas aeruginosa (36.1%) was one of the most common organisms to cause CSOM. followed by Staphylococcus haemolyticus. Staphylococcus epidermidis and Staphylococcus aureus. There was a significant difference between the germ pattern and the type of CSOM (p = 0.002). Amikacin. meropenem. gentamicin. cefepime. ciprofloxacin and ceftazidime were found to be the most effective antibiotics for Pseudomonas aeruginosa. The rate of resistance to tigecycline and cefazoline were highest. Age. sex. nutritional status and comorbidities were not factors that significantly influenced the incidence of cholesteatoma in CSOM.
 Conclusion: There is a significant difference between the germ pattern in both CSOM groups. Patients that show Gram negative have a significant effect on the incidence of CSOM with cholesteatoma.

EVALUATION OF ASSOCIATED RISK FACTORS IN CHRONIC SUPPURATIVE OTITIS MEDIA PATIENTS REPORTED IN COMMUNITY HEALTH CENTER, CHENANI

Background: Chronic suppurative otitis media or CSOM is characterized by recurrent or persistent ear discharge, or otorrhoea, for a period of 2 to 6 weeks, through the tympanic membrane perforation. Studies often present a varying incidence of CSOM, but it is the most important cause of deafness in India. Risk factors are mainly associated with low socioeconomic status, crowded atmosphere, low parental education level, poor nutrition, frequent upper respiratory tract infection and chronic diseases. Methods: A retrospective- observational study of 300 patients of CSOM, selected from OPD of the Department of Otorhinolaryngology, CHC, Chenani, Udhampur, Jammu, J&K, was conducted during August 2018 to January 2019. Detailed clinical examination was done and statistical socio-demographic analysis was performed. Associated factors of CSOM were also recorded and a resultant chart was obtained. Results: Our study showed that urban as well as rural poor were equally affected population. Highest incidence found in the range of 11 to 20 years (36.67%), with only 54 (17.67%) cases reported for age group: 41 and above. 55.33% of cases pertained to lower Socio-economic status with major occupational incidence amongst urban labour class (82/300, i.e. 27%). The major contributing factor for CSOM came out to be the crowded living conditions (52.0%) and aseptic and unsupervised handling or ears (49.0%). Conclusions: Congestion and crowded household, bathing in contaminated ponds and canals, unsterile ear piercing, constituted significant risk factors, therefore preventive strategies and awareness program, based upon the above, should be planned to counter the burden of CSOM. Key words: Chronic Suppurative Otitis Media (CSOM), Ear Discharge, Socio-demographic Status

Modern approaches to the diagnosis of vestibulopathy in patients with chronic suppurative otitis media

Chronic suppurative otitis media (CSOM), according to statistics, is one of the most common diseases in otorhinolaryngological practice, accounting for, on average, from 5.8 to 20.7% of all ENT pathology. The incidence of CSOM in the Republic of Uzbekistan is up to 6.5%. The pathological process in CSOM leads to the destruction of the bone structures of the middle ear and progressive hearing loss, and in some cases - to an increase in vestibular symptoms. Purpose of the study: vestibular disorders in chronic purulent otitis media using modern diagnostic methods. Materials and methods: In order to study the features of cochleovestibular disorders in CSOM, in the Department of Congenital and Acquired ENT Diseases at the Republican Specialized Scientific and Practical Medical Center of Pediatrics of the Ministry of Health of the Republic of Uzbekistan were examined 13 patients with CSOM with labial complications . All patients underwent a set of standard examinations: ENT examination, otoscopy with video recording, stato coordination tests, complex vestibulometry using modern computer video nystagmography, a set of audiometric tests, computed tomography of the temporal bones. Results: 38.4% of patients complained of dizziness, but when using the method of active survey complaints of dizziness were detected in 61.5% of cases. The analysis of the results of stato-coordination tests in 30.7% of patients revealed a deviation towards the affected ear, in 61.5% of cases - spontaneous nystagmus. Conclusions: the results allow us to conclude that the main complaint of patients with CSOM are of hearing loss (100%), discharge from the ear cavity (100%), complaints of vestibular manifestations were present in 30 to 55% of subjects. Detection of mixed deafness in 53.8% of patients during audiological examination indicates involvement in the process of the inner ear, hence all patients with CSOM, regardless of the duration and stage of the inflammatory process, should conduct a comprehensive vestibulometric examination to determine vestibular status, the degree of involvement of inner ear structures , prognosis, choice of treatment tactics and prevention of complications.

MICROORGANISMS PROFILE AND ANTI-MICROBIAL SENSITIVITY IN CHRONIC SUPPURATIVE OTITIS MEDIA

OBJECTIVE: To determine the frequency of common microorganisms involved in chronic suppurative otitis media (CSOM) and their antibiotic sensitivity.METHODS: This cross sectional study of 776 patients suffering with CSOM was conducted at Otolaryngology Department, Ayub Teaching Hospital, Abbottabad from 5th May 2017 to 5th November 2018. Patients fulfilling the inclusion criteria were enrolled for otoscopic examination. Sterile cotton swabs were used to collect pus samples and were sent to microbiological analysis and antibiotics sensitivity.RESULTS: The age ranges of the patients were from 13-73 years, with a mean age of 28.98±13.40 years. The incidence of CSOM was highest in 21-30 years age group (294~37.9%). In a total 776 CSOM patients, only 501 (64.56%) of the samples showed microbial growth. In aerobic isolates, the most common bacterium was Pseudomonas aeruginosa (30.7%) followed by Staphylococcus aureus (11.1%) including 6.7% MRSA. Anaerobes were isolated in 1.2% of the samples in which bacteriodes were being the most common. Samples (1.8%) showed fungal growth and yielded only Candida spp while 0.5% samples were positive for acid fact bacilli. In antimicrobial sensitivity investigation Pseudomonas aeruginosa showed highest sensitivity to piperacillin/tazobactum (84%), to levofloxacin (25.21%), to ciprofloxacin (20.59%). The highest sensitivity of S. aureus was investigated for piperacillin/tazobactum and ceftazidime with 91.18%, and showed no sensitivity to ciprofloxacin and levofloxacin.CONCLUSION: Pseudomonas aeruginosa and Staphylococcus aureus were the most common bacteria. Both show increasingly high resistance to quinolones and amino glycosides, but both isolates are sensitive to piperacillin/tazobactum, imipenam, cefoperazone/salbactum and ceftazidime.

BIOFILM BACTERIA PLAYS A ROLE IN CSOM PATHOGENESIS AND HAS SIGNIFICANT CORRELATION WITH UNSAFE TYPE CSOM

Chronic suppurative otitis media (CSOM) may cause severe morbidity and mortality and remains a major health problem worldwide. The incidence of CSOM in Indonesia (1994-1996) is estimated at about 8.36 million people and CSOM general prevalence is 3.8% (Helmi 2005). This study aims to prove the existence of bacterial biofilm in patients with safe type and hazard type CSOM from mastoidectomy. The design was observational analytic with cross sectional approach. This study was conducted at the Teratai Wards, IBP Dr. Soetomo Hospital, and Electron Microscopy Unit, Faculty of Medicine, Airlangga University Surabaya, from November 2013 to June 2014. Samples of pathological tissues were taken by consecutive sampling and bacterial biofilms examination was done by SEM. SEM results categorized the biofilm bacteria as positive or negative. Biofilm bacteria tested positive when it shows three-dimensional representation of bacteria with clear shapes and sizes and clusters, the formation of amorphous material consisting of glycocalyx material surrounding the bacteria, and surface attachment. Biofilm bacteria was regarded as negative when there is no bacterial cluster, glycocalyx and surface attachment. This study was performed on 33 CSOM patients. Samples were divided into unsafe type CSOM (17 patients) and safe type CSOM (16 patients). Positive biofilm bacteria was found in 12 patients with unsafe type (75%) and 6 patients with safe type (35.35%). Negative biofilm bacteria was found in 4 patients with the unsafe type (25%) and 11 patients with safe type (67.9%). Logistic regression analysis revealed p value = 0.027, indicating the biofilm bacteria have a significant correlation with unsafe type CSOM (p <0.05). In conclusion, biofilm bacteria plays a role in CSOM pathogenesis of biofilm bacteria has significant correlation with unsafe type CSOM.

Role of CT Mastoids in the Diagnosis and Surgical Management of Chronic Inflammatory Ear Diseases.

Chronic Suppurative Otitis Media (CSOM) is a chronic inflammation of middle ear cleft. It presents with discharging ear and decreased hearing. The diagnosis is mostly on clinical examination with otoscope or oto endoscope. Computerised Tomography (CT) of mastoids is done to evaluate the extent of the disease and its complication. High resolution CT is now the investigation of choice for temporal bone disease. This study emphasizes on the importance of CT scan in diagnosis of inflammatory ear diseases and most importantly identifying pitfalls or complications which a surgeon can come across during surgery. The aims and objectives of this study is (1) to establish the efficacy of CT in the diagnosis of the complications and surgical management of chronic inflammatory pathologies of middle ear. (2) To find subgroups of CSOM where CT is particularly useful. In this series, a total of 25 cases presenting to our OPD at Govt. ENT Hospital between 2013 and 2014 have been diagnosed and findings of surgery correlated with HRCT scan of temporal bones done preoperatively. In this study, 64% of the patients were male and incidence of CSOM with patients undergoing surgery belonged to the age group 21-30years (32%). The most common presenting symptom was ear discharge (92%) and decreased hearing (96%). The most common type of pathology in this study was attic perforation (36%) and granulations (40%) followed by cholesteatoma (36%) and mucosal edema (16%). Not all cases presented with complications, facial palsy (12%) and mastoid abscess (8%) were among few complications seen. 14 patients (56%) of 25 cases underwent simple cortical mastoidectomy followed by 9 cases (36%) for modified radical mastoidectomy and atticotomy for 2 cases (8%). CT scan findings correlated well with surgical findings for cholesteatoma, middle ear mass and bone erosions. Where as for ossicular integrity and facial canal dehiscence, there was a discrepancy.

Chronic suppurative otitis media following paediatric cochlear implantation

The objective of this study was to report and discuss the management of chronic suppurative otitis media (CSOM) following cochlear implantation in children. The study was a retrospective review of 650 patients receiving an implant at two paediatric tertiary referral centres for cochlear implantation. Nine patients were identified who developed CSOM following cochlear implantation (incidence 1.38%). The mean time interval between implantation and symptom development was 3.66 years (range 2–8 years) and the mean time interval between implantation and CSOM surgery was 5.02 years (range 2.2–8 years). All patients presented with otorrhoea and/or abscess formation over the implant site. Two patients underwent a modified radical mastoidectomy and seven underwent a combined approach tympanoplasty, three of whom required posterior canal wall reconstruction with cortical bone and one with cartilage. In four cases it was possible to remove the cholesteatoma without removing the implant. All but two patients were fitted with a contralateral implant. In the explanted ears the cochlear implant electrode was cut at the cochleostomy site, which was then covered with muscle. Chronic suppurative otitis media following cochlear implantation may occur either as a result of a posterior canal wall defect related to surgery or possibly de novo. Attempts should be made to save the implant, but explantation with reimplantation of the contralateral ear may be the only option. In these cases the intracochlear part of the electrode array should be left in situ to facilitate possible future reimplantation. Surgical options for management of CSOM should be individualized and may include both canal-wall up and canal-wall down techniques. To reduce the incidence of CSOM following implantation the authors recommend: (1) prompt treatment and careful follow-up of patients with a history of otitis media with effusion, (2) avoidance of excessive thinning of the posterior canal wall during mastoidectomy and (3) reconstruction of any accidental trauma to the annulus or posterior canal wall during posterior tympanotomy. Copyright © 2006 John Wiley & Sons, Ltd.

Epidemiology of chronic suppurative otitis media among Saudi children—a comparative study of two decades

An epidemiological survey to study the prevalence of chronic suppurative otitis media (CSOM) was completed in February 2000. About 9540 children aged up to 12 years were examined clinically by an otolaryngologist. All 125 children (1.3%) suffered from CSOM, nine with cholesteatoma. The prevalence of CSOM in the Central province of the Kingdom was found to be 1.15%. During the first study done in 1982, the prevalence was 5.5% among 293 children aged 6–18 years. In the second study done and completed in 1991 where 6421 children were surveyed, 94 children found to suffer from CSOM i.e. 1.5% with six children having cholesteatoma. These results showed a decrease in incidence of CSOM in the Central province, although in other parts of the Kingdom, the prevalence was found to be as high as 2.89%. The factors predisposing to or associated with chronic ear disease will be discussed, and the results will be compared with results published from other centers.

Chronic Suppurative Otitis Media — A prospective study

A random selection of 120 cases of Chronic Suppurative otitis Media (CSOM) were investigated for bacterial and fungal isolates at the Department of Microbiology and Parsitology, Benghazi. The specimens were obtained from the out- patient department of Otolaryngology of 28th March Polyclinic. The incidence of CSOM in Benghazi was found to be 23.7%. A total of 145 bacterial isolates were identified and their susceptibility to various antibiotics was tested. Staphylococcus aureus was the predominant pathogen isolated (42.5%), followed by Pseudomonas aeruginosa (21.6%) and proteus species (18.33%). Fungi were isolated from 7.5% of cases, but no growth was observed in 10% of specimens collected. The majority of the bacterial isolates showed multiple drug resistance. Gentamycin still formed the drug of choice in treating the causative strains of either Gram positive or Gram negative bacteria, while tetracycline was found to be the least effective.