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Evaluation of Role of Mastoid Surgery in the Management of Safe Chronic Suppurative Otitis Media.

ABSTRACT: This study evaluates the outcome of type 1 tympanoplasty with and with out mastoidectomy. The comparative study comprises of 40 patients with CSOM safe type in dry ear. All cases were operated during a period of one and a half years. 20 of these cases were selected for tympanoplasty alone (Group A) and 20 cases were selected for Tympanoplasty with cortical mastoidectomy (Group B). Patients were reviewed after 3 weeks for inspection of the operated ear. The second and third postoperative reviews were done 6 and 12 weeks respectively for clinical assessment of the operated ear with respect to graft status, ear discharge and hearing improvement. The postoperative audiograms were recorded after 3 months. Type I tympanoplasty with cortical mastoidectomy has better graft uptake (100 %) as compared to without mastoidectomy (95 %). Post-operative A-B gap closure is better in tympano-mastoidectomy (20.48 dB) than tympanoplasty (15.75 dB) with p value <0.05. Post-operative hearing gain and graft uptake were both better with tympano-mastoidectomy and tympanoplasty.

SUBMITTER: Sharma A

PROVIDER: S-EPMC5083644 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Evaluation of Role of Mastoid Surgery in the Management of Safe Chronic Suppurative Otitis Media.

Sharma Akriti A Baisakhiya Nitish N Garg L N LN Singh Gurchand G

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India 20151013 4

This study evaluates the outcome of type 1 tympanoplasty with and with out mastoidectomy. The comparative study comprises of 40 patients with CSOM safe type in dry ear. All cases were operated during a period of one and a half years. 20 of these cases were selected for tympanoplasty alone (Group A) and 20 cases were selected for Tympanoplasty with cortical mastoidectomy (Group B). Patients were reviewed after 3 weeks for inspection of the operated ear. The second and third postoperative reviews ...[more]

PMID: 27833868

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Project description:BackgroundChronic suppurative otitis media (CSOM) is an important cause of hearing loss in children and constitutes a serious health problem globally with a strong association to resource-limited living conditions. Topical antibiotics combined with aural toilet is the first-hand treatment for CSOM but antimicrobial resistance and limited availability to antibiotics are obstacles in some areas. The goal of this study was to define aerobic pathogens associated with CSOM in Angola with the overall aim to provide a background for local treatment recommendations.MethodsSamples from ear discharge and the nasopharynx were collected and cultured from 152 patients with ear discharge and perforation of the tympanic membrane. Identification of bacterial species was performed with matrix-assisted laser desorption/ionization-time of flight mass spectrometry and pneumococci were serotyped using multiplex polymerase chain reactions. Antimicrobial susceptibility testing was done according to EUCAST.ResultsOne hundred eighty-four samples from ear discharge and 151 nasopharyngeal swabs were collected and yielded 534 and 289 individual isolates, respectively. In all patients, correspondence rate of isolates from 2 ears in patients with bilateral disease was 27.3% and 9.3% comparing isolates from the nasopharynx and ear discharge, respectively. Proteus spp. (14.7%), Pseudomonas aeruginosa (13.2%) and Enterococcus spp. (8.8%) were dominating pathogens isolated from ear discharge. A large part of the remaining species belonged to Enterobacteriaceae (23.5%). Pneumococci and Staphylococcus aureus were detected in approximately 10% of nasopharyngeal samples. Resistance rates to quinolones exceeded 10% among Enterobacteriaceae and was 30.8% in S. aureus, whereas 6.3% of P. aeruginosa were resistant.ConclusionsThe infection of the middle ear in CSOM is highly polymicrobial, and isolates found in nasopharynx do not correspond well with those found in ear discharge. Pathogens associated with CSOM in Angola are dominated by gram-negatives including Enterobacteriaceae and P. aeruginosa, while gram-positive enterococci also are common. Based on the results of antimicrobial susceptibility testing topical quinolones would be the preferred antibiotic therapy of CSOM in Angola. Topical antiseptics such as aluminium acetate, acetic acid or boric acid, however, may be more feasible options due to a possibly emerging antimicrobial resistance.

Dataset Information

Evaluation of Role of Mastoid Surgery in the Management of Safe Chronic Suppurative Otitis Media.

Publications

Evaluation of Role of Mastoid Surgery in the Management of Safe Chronic Suppurative Otitis Media.

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