Effect of Surgical Treatment of Sinonasal Pathology on the Outcome of Active Mucosal Chronic Otitis Media
Journal Title: Journal of Medical Science And clinical Research - Year 2015, Vol 3, Issue 3
Abstract
Objectives: To determine the role of sinonasal pathology in the disease process of active mucosal chronic otitis media and to evaluate the effect of surgical treatment of sinonasal abnormalities on the outcome of active mucosal chronic otitis media Materials and Methods: 100 consenting adults aged 20-60 years, with chronic rhinosinusitis and uncomplicated active mucosal chronic otitis media (persisting otorrhoea for 12 or more weeks following culture directed antibiotics) were included. Evaluation including diagnostic nasal endoscopy, otomicroscopy, computerised tomogram of the paranasal sinuses and brain, and culture and sensitivity were conducted. Functional endoscopic sinus surgery, with concomitant correction of nasal abnormalities, was performed and postoperative (otomicroscopy) follow up at 1week, 1, 3, 6months was carried out. Results: Mean age of the patients (58males and 42 females) was 29.6±2.73years.Majority (61%) were in the lower income group. Chronic otitis media was present bilaterally in 62% and unilaterally in 38%, coinciding with laterality of detectable disease in the nose/paranasal sinuses. Cultures isolated 56% Gram negative and 54% Gram positive organisms; Pseudomonas was the commonest pathogen in the ear and Coagulase positive staphylococcus in the nose/paranasal sinuses. Postoperatively, 85% had dry ears at the end of 6 months. Conclusion: Infection/inflammation of nose/paranasal sinuses is associated with inadequate resolution of active mucosal chronic otitis media. Surgical correction of anatomical abnormality(s) of the nose with functional endoscopic sinus surgery for the treatment of chronic rhinosinusitis reduces inflammation/discharge of the middle ear. Surgical treatment of sinonasal pathology is thus indicated before undertaking ear surgery.
Authors and Affiliations
Dr. B. V. Chandre Gowda
Keywords
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