Clinico-Microbiology of Cholesteatoma Obtained During Mastoid Surgery in Patients With Chronic Suppurative Otitis Media

Abstract

Chronic Otitis Media (COM) is a long standing inflammation of the middle ear and mastoid, it is a common health problem. The evidence of microbiology in COM in different studies showed variable frequencies, but little studies showed the role of fungal colonization. This study aimed to identify the microbiology of cholesteatomatous COM concentrating on clarification of fungal colonization. A prospective study was done in otolaryngology department of Basrah Teaching Hospital from June 2018 till July 2019. This study was carried on a randomly collected data of 25 patients diagnosed as COM by a specific designed questionnaire including history and examination. The specimen was collected during mastoid surgery which included any cholesteatoma in the middle ear and mastoid and sent for bacteriological and mycological examination. Statistical study was done by using SPSS v.23 Bacteria were isolated in 84% of the cases in which Pseudomonas aeruginosa was the commonest one (33.3%). Fungi were isolated in 28% cases, in which the Aspergillosis was the commonest (19.3%). There is no recognizable pattern of significant association between the fungi and the reported complications or the stage of the disease. In conclusion, there is significant percentage of fungal colonization in COM with cholesteatoma so it may has a role in inflammatory response of perimatrix, but there is no clear mechanism of this interaction, so may need larger sample and longer duration of study with postoperative follow-up and trail of combined antibiotic-antimycotic treatment.