Predisposing Sinonasal Disease Foci: Do They Really Affect Mucosal Chronic Otitis Media?

Abstract

Background This study aimed to find the relationship between sinonasal predisposing foci in chronic otitis media mucosal disease (COMMD) and risk from these predisposing disease foci, and to identify the correlation of bacterial flora of the ear and nose in chronic otitis media. Materials and Methods This was a prospective case–control study with 100 cases and 100 controls. All patients underwent a detailed clinical ear-nose-throat (ENT) examination and diagnostic nasal endoscopy to look for sinonasal and pharyngeal pathology. In all patients, ear and nasal swabs were taken at the first visit. The relationship between these factors and COMMD was studied by appropriate statistical tests. Observations and Results Extremely significant association between tubal tonsil hypertrophy and COMMD, very significant association between adenoid hypertrophy and COMMD, and just significant association between deviated nasal septum, inferior turbinate hypertrophy, concha bullosa, and COMMD were found. No significant association was found between sinusitis and COMMD. In this study Staphylococcus aureus (51%) was the predominant organism isolated from ear swab, followed by Pseudomonas (27%). The same organism in nasal and ear swabs was demonstrated only in eight (13%) cases. Conclusion Sinonasal predisposing foci play a substantial role in the development of COMMD and observed in 97% of the cases with bilateral disease and 91% with unilateral disease in this study. Hence, every case of COMMD must undergo investigations such as diagnostic nasal endoscopy to discover these foci. Because sinonasal disease is one of the important factors contributing to otitis media, timely detection and management of symptomatic sinonasal disease must precede surgical management of COMMD.

Evaluation of Eustachian Tube Function in Mucosal Chronic Otitis Media: A Cost-Effective Method for Developing Countries

“…10 As revealed in our previous study, even though a majority (> 90%) of the cases with COM have some or the other "predisposing disease focus" in the sinonasal region, it may not necessarily lead to an ET dysfunction. 9 Our data show that the ET function could get affected even in patients with traumatic TM perforation. This means that the ET dysfunction may not necessarily lead to COM all the times.…”

“…Many times, it is difficult to distinguish a physiological structure such as an anatomical variation from a definitive pathological focus in the nose and paranasal sinuses, as revealed in our previous study. 9 Also, it is difficult to establish to what extent the disease focus directly or indirectly affects the functioning of the ET. It has been shown that there is a tendency for poor ET function in patients with nasal septal deviation.…”

Persistent adenoids and their secondary effects

“…In one of our own previous studies, we have discovered that the adenoids could pose a considerable risk factor for the development of chronic otitis media. 1 This paper aimed to study the clinicopathological features of persistent adenoids and their secondary effects on the upper respiratory tract.…”