Prevalence of cholesteatoma in chronic suppurative otitis media with central perforation

Rout, Manas Ranjan; Mohanty, Diganta; Vijaylaxmi, Y; Kamalesh, B; Chakradhar, M

doi:10.4103/0971-7749.98280

Cited by 40 publications

(32 citation statements)

References 6 publications

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“…Existing evidence suggests that presence of granulation tissue is one of the best predictors of ossicular necrosis and its prevalence in tubotympanic disease was 9.5 %. Sample size was calculated as 69 using the formulae 4PQ/d 2 with absolute precision of 7 [3]. Those with more than 15 years of age with tutotympanic chronic suppurative otitis media and scheduled to undergo tympanoplasty with or without cortical mastoidectomy were included whereas patients who were with attico antral CSOM, marginal perforation and previous history of ear surgery in the same ear were excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

Pre-operative Indicators of Ossicular Necrosis in Tubotympanic CSOM

Jayakumar

Inbaraj

Pinto

2016

Indian J Otolaryngol Head Neck Surg

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Ossicular necrosis and erosion is commonly seen in CSOM with cholesteatoma but can also occur in tubotympanic CSOM. This usually comes as a surprise during surgery. Preoperative knowledge of ossicular necrosis helps the surgeon to be better prepared for the surgery and ossicular construction if required. Hence, this study is intended to identify the pre-operative indicators of ossicular necrosis. This cross sectional study was conducted in Father Muller Medical College in Mangalore. Sixty nine consecutive patients with tubotympanic CSOM underwent a detailed clinical examination with pure tone audiometry and subsequently tympanoplasty with or without cortical mastoidectomy. All clinical findings, pure-tone audiometry, and intraoperative otomicroscopic observations were recorded. Incidence of ossicular necrosis was 23 %. The incus was most frequently eroded followed by malleus and then stapes. On bivariate analysis patients age above 30 years (p = 0.05), duration of CSOM more than 10 years (p = 0.02), presence of granulation (p \ 0.05), absence of tympanosclerosis (p = 0.01), moderately severe (45-60 dB) hearing loss (p = 0.01) and an air bone gap of more than 55.7 dB in the right ear and 63.95 dB in the left ear was found to be statistically significant (p \ 0.05). On multivariate analysis only presence of middle ear granulation tissue was found to be the significant predicator [(p = 0.005), OR 14.37, 95 % CI 2.26-90.0]. The presence of granulation tissue and a wide air bone gap on pure tone audiometry were the best indicators of ossicular necrosis. Preoperative identification of these indicators can help the surgeon to be better prepared for the surgery.

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Section: Methodsmentioning

confidence: 99%

Pre-operative Indicators of Ossicular Necrosis in Tubotympanic CSOM

Jayakumar

Inbaraj

Pinto

2016

Indian J Otolaryngol Head Neck Surg

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“…Of these innumerable studies, those that closely resemble the social, anthropological and cultural characteristics of our study participants have been reviewed to refresh our concepts related to the pattern of this disease. [4][5][6][7] The aim of this cross sectional study was to acknowledge the changing trends in the presentations and of atticoantral type of chronic suppurative otitis media with or without complications.…”

Section: Introductionmentioning

confidence: 99%

Clinico social profile of patients of attico-antral disease in middle ear cleft attending tertiary care center of North India

2016

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“…1 In developed countries the incidence of CSOM has decrease but is higher in developing countries attributed to various factors like because of malnutrition, low socioeconomic society, poor personal hygiene, recurrent upper respiratory tract infection and lack of adequate primary health care facilities. [2][3][4] Inadequate treatment of CSOM may lead to serious intra-cranial and extra-cranial complications like facial nerve paralysis, meningitis, mastoid abscess, deafness, lateral sinus thrombosis and intracranial abscess.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and antibiotic susceptibility of Pseudomonas aeruginosa isolated from chronic suppurative otitis media

Deshmukh¹,

Manthale²

2016

Int J Otorhinolaryngol Head Neck Surg

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2 INTRODUCTIONChronic suppurative otitis media (CSOM) is the most common middle ear infection characterized by recurrent ear discharges or otorrhoea through a tympanic perforation from the middle ear.1 In developed countries the incidence of CSOM has decrease but is higher in developing countries attributed to various factors like because of malnutrition, low socioeconomic society, poor personal hygiene, recurrent upper respiratory tract infection and lack of adequate primary health care facilities.2-4 Inadequate treatment of CSOM may lead to serious intra-cranial and extra-cranial complications like facial nerve paralysis, meningitis, mastoid abscess, deafness, lateral sinus thrombosis and intracranial abscess. 5Although the complication are less common now due to availability of broad spectrum antibiotics, the resistance of the causative organisms is very common. 6 The organisms isolated from CSOM include both aerobic (e.g. Pseudomonas aeruginosa) and anaerobic bacteria (e.g. ABSTRACTBackground: Chronic suppurative otitis media (CSOM) is the most common middle ear infection characterized by recurrent ear discharges or otorrhoea through a tympanic perforation from the middle ear. The organisms isolated from CSOM include both aerobic and anaerobic bacteria. Among the bacteria, Pseudomonas aeruginosa (P. aeruginosa) has been particularly blamed for deep seated and progressive destruction of middle ear and mastoid structures through its toxins and enzymes. The present study was done to determine the prevalence and antibiotic susceptibility of P. aeruginosa isolated from CSOM. Methods: This was a retrospective study conducted in a tertiary care hospital in South India in March 2016. Data was obtained from the microbiology records from January 2014 to January 2016. Patients who had active ear discharge for at least three months were included in the study. P. aeruginosa was identified by colony morphology, pigment production, characteristic musty or earthy odor. The identification was confirmed by motility and standard biochemical tests. Results: A total of 293 cases of CSOM were included in the study. Microbial growth was seen in 248 (84.6%) cases and remaining 45 cases did not show any growth. Among 248 bacterial growth, 87 (35%) were positive for P. aeruginosa. Most common organism was P. aeruginosa followed by Staphylococcus aureus. Highest resistance was seen with Gentamicin and Ofloxacin and least resistance with Imipenem. The increased resistance to Cephalosporin group is warning sign, as these are potent anti-Psuedomals. Conclusions: P. aeruginosa and Staphylococcus aureus were found to be the common cause of CSOM in the present study. P. aeruginosa was resistant to commonly used antimicrobials. There was no resistance seen with Imipenem and only two strains were resistant to Piperacillin+tazobactum. Regular evaluation of the microbiological pattern and antibiogram of isolates will help in decreasing the complications of CSOM.

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Prevalence of cholesteatoma in chronic suppurative otitis media with central perforation

Cited by 40 publications

References 6 publications

Pre-operative Indicators of Ossicular Necrosis in Tubotympanic CSOM

Pre-operative Indicators of Ossicular Necrosis in Tubotympanic CSOM

Clinico social profile of patients of attico-antral disease in middle ear cleft attending tertiary care center of North India

Prevalence and antibiotic susceptibility of Pseudomonas aeruginosa isolated from chronic suppurative otitis media

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