Challenges in the Management of Adult Chronic Suppurative Otitis Media in Port Harcourt Nigeria.

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Challenges in the Management of Adult Chronic Suppurative Otitis Media in Port Harcourt Nigeria.

Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 1

Abstract

Background: Chronic Suppurative Otitis Media (CSOM) cuts across all age groups and its management has been revolutionized by the use of microscopes and other modern equipments in developed countries. Prompt diagnosis and appropriate management is the key to good clinical recovery. This study established the clinical profile of adult CSOM in Port Harcourt Nigeria and highlighted its management challenges. Patients And Methods: This was a retrospective study of adult patients who presented to the department of Ear Nose and Throat (ENT) surgery of the UPTH, Port Harcourt from January 2002 to December 2012. The patient’s data were retrieved from the clinic registers and patients’ case notes. Demographic data, clinical presentation, etiological factors, site of tympanic membrane perforation, affected ear, treatment modalities and challenges encountered during the management of patients were recorded and analyzed. Results are represented in percentages, frequency tables and pie charts. All statistical analysis was done using the SPSS version 21 software. Results: Eight hundred and thirty six patients were found to have CSOM. These constituted 12.8% of all otorhinolaryngological cases seen within the study period. There were 404 males and 432 females (male: female ratio of 1.0:1.1). Age range was 18 to 94 years, mean = 38.8 +/- 10.4 years. Age group 18-28 years has the highest (n=412, 49.3%) number of cases. Bilateral CSOM accounted for the highest number (n=500, 59.8%) of cases. Perforation was found more on the antero inferior aspect of the tympanic membrane and the commonest etiological factor was trauma from the use of cotton buds (n= 350, 41.9%). Among the elderly most of them the condition was carried over from childhood and they don’t know the cause. The commonest mode of treatment was conservative medical treatment. Conclusion: This study confirmed a prevalence of 12.8 % of CSOM among adult patients that attended the ENT clinics in UPTH, Port Harcourt. The commonest type seen was the tubo-tympanic disease. Trauma was found to be the commonest etiological factor. Conservative medical treatment was the commonest mode of treatment. However, lack of surgical expertise for otologic surgeries and facilities constituted a major challenge in the management of patients with CSOM.

Authors and Affiliations

Onotai L. O, Oparaodu Ureh

Keywords

Chronic Suppurative Otitis Media tubotympanic disease antico-antra disease conservative medical treatment tympanic membrane perforation surgical treatment.

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EP ID EP590327
DOI 10.9790/0853-1601088690
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