European Journal of Molecular & Clinical Medicine

Introduction: Back ground: Chronic suppurative otitis media (CSOM) is one of the most common childhood infectious diseases worldwide and is a leading cause of hearing impairment in resource-limited settings. It is less frequently seen in resource-rich settings. It is characterized by chronic drainage from the middle ear associated with tympanic membrane (TM) perforation. CSOM is usually preceded by an episode of acute otitis media (AOM).
Aim and Objective of the study. The aim and objectives of the study is to evaluate the surgical outcomes chronic suppurative otitis media.
 Materials and Methods: Informed consent was obtained from all patients included in the study. The study was approved by institutional ethical committee. The data were collected by the active participation of the patients’ interview by the preformed proforma of data collection sheet and then data were gathered and tabulated. Detail history, physical examination and relevant investigations were done pre-operatively and post-operatively. Post-operative follow up after 1month, 2 months and 3 months were done.
Results and Discussion: In the present study, we included a total of 80 patients with CSOM who underwent surgical intervention. The aim and objectives of the study is to evaluate the surgical outcomes chronic suppurative otitis media. The number of subjects in the age group of 5-10 years were 3, 11-20 years were 20, 21-30 years were 15, 31-40 years were 22 and 41-50 years were 20. The number of males were 62% and females were 38%. It is evident from the table 2 that 100% presented with discharge, 22.5% with granulation tissue, 21.25% with aural polyp, 55% with attic perforation and 35% with postero-superior marginal perforation. It is evident from table 3 that 52.5% had dry ear, 15% had discharging ear and 1.25% had granulation tissue at 1^st month. Similarly, that 55% had dry ear, 10% had discharging ear and none of the subjects had granulation tissue at 3^rd month. It is evident from table 4 that 3.75 % had deterioration, 8.75% had unchanged and 87.5% had improvement in hearing.
Conclusion: Hearing loss arising from COM is a matter of serious concern because of its long-term effects on communication, language development and educational process. Early diagnosis and intervention by skilled Otologist is recommended to regain hearing as well as to prevent disability and complications.

Chronic otitis media is a mucoperiosteal chronic inflammation in the middle ear
cleft which is associated with perforation of the tympanic membrane, ear
discharge and hearing impairment. The main goal of tympanoplasty is the
reconstruction of the tympanic membrane and closure of a perforation that has
been impaired by chronic ear diseases with or without trying to improve the
hearing mechanism.

Background: CSOM and associated hearing loss is significant in our society and an effort directed towards the assistance of those who are afflicted is indeed worthwhile. The problem of ossicular reconstructions for CSOM in difficult chronic ears however continues to represent a major rehabilitation challenge. Various materials have been used in reconstruction of middle ear including synthetic, bony and cartilaginous materials.
Methods: The present study was prospective observational study of 50 cases who underwent ossiculoplasty for middle ear surgery over the period of 2 and half years. CSOM patients with hearing loss >40 dB were included and patients with sensorineural hearing loss were excluded out from the study. Otoscopic examination, tuning fork tests, and examination under microscope were done in all the patients.
Results: A total number of 50 patients were included in the study. Graft was taken up in 90% cases and rejected in 5% subjects after 3 months postoperatively. The average pre-operative air-bone gap was 45±3.60 dB while the average post-operative air-bone gap was 25.66±9.25 dB. The average hearing gain was 19.34 dB which was statistically significant (p=0.000).
Conclusions: This study concluded that ossiculoplasty with an autologous incus graft is safe surgical approach with good results for reconstructing the ossicular chain due to lower extrusion rate with good post-operative hearing gain.

Background: Despite the rise in antibiotics use,complications of chronic suppurative otitis media(CSOM)remain quite frequent, have high morbidity and mortality rates, and pose a challenge to the otolaryngologist especially in developing countries like India.The present prospective study was conducted at our tertiary care hospital to evaluate the clinico pathological profile of Extracranial complications of CSOM and their management.
Materials And Methods: We analysed all patients presenting with Extracranial complications with regards to their age,sex distribution and types of complications and types of  surgical management.
Result: In our study a total of 50 cases of Extracranial complications were reviewed in the study period of 2yrs.Of the total 50 cases, 32 cases were male and 18 cases were females. Age distribution of the patients ranges from 4 - 70 yrs with a mean age of 37 yrs. Of these 22 patients(44%) had mastoiditis alone as a complication of CSOM,subperiosteal abscess in 14 patients (28%), 7 cases (14%) had Postauricular fistula. 4 cases (8%) of Facial nerve weakness and 3 cases(6%) of Labyrinthitis.  Surgery was the main modality of treatment of which Canalwall down mastoidectomy was done in 25 cases (50%), intact canal wall mastoidectomy in 16 cases (32%)and cortical mastoidectomy in 9 cases(18%).
Conclusion: Extracranial complications of CSOM are rare today, but they still have a hazardous potential.Early diagnosis and prompt treatment reduce the incidence and improve quality of life in these patients. Our study emphazizes the same,and we hope to generate some awareness leading to further reduction in morbidity and mortality.

INTRODUCTION: Hearing is one of the most important senses of man which provides him
with the ability to perceive the world and also helps him in communication.Chronic suppurative
otitis media (CSOM),a tremendous health predicament since time immemorial, is a chronic
inflammation of the middle ear cleft which may lead to serious sequelae and complications. The
wide spread use of antibiotics has precipitated the emergence of multiple resistant strains of
bacteria which can produce both primary and postoperative infections.
MATERIALS AND METHODS: This is a Prospective studyconducted at Department of
Microbiology,Tertiary care teaching hospitalover a period of 1 year with200 samples were
collected from patients attendingat out Patient department of ENT included in the study.After
cleaning the external ear with alcohol, ear discharge is collected aided by a Bull lamp and aural
speculum with absorbable sterile cotton swabs under strict aseptic precaution.
RESULTS: Analysis of these cases of CSOM in both sexes and age groups as shown in Table -
1: revealed that the majority of cases of CSOM were in the age 11-20yrs in both sexes .The
overall incidence of CSOM was found to be more in males 117 than in females 83 and this
predominance was noted in all the age groups.The details of anaerobic organisms isolated in
csom cases.Bacteroidsfragilis is the predominant organism followed by peptosteptococcus.All
anaerobes were 100% sensitive to Metronidazole.
CONCLUSION:Out of 200 samples 14 anaerobic organisms were isolated of which
Bacteroidesfragilis 4(28.6%) were predominant anaerobes followed by Peptostreptococcus
species 3(21.4%).This sudy is designed to have the knowledge of the pathogens and antibiotic
sensitivity pattern responsible for CSOM and choosing suitable antibiotics according to
susceptibility tests should guide the management of disease treatment and reduce the recurrence
and complications of CSOM.

Aim: The aim of the study is to compare the results of myringoplasty performed using
temporalis fascia with that of tragal perichondrium.
Methodology: A Hospital based prospective study was conducted to compare the
success rate of myringoplasty performed with temporalis fascia versus tragal
perichondrial grafting at department of ENT,Govt ENT Hospital,Koti,Hyderabad..
Patients with chronic suppurative otitis media with tubo tympanic type were included
in the study.
Results: A total of 60 patients were studied among which 30 were in group A and 30 in
group B. Patients were diagnosed by clinical examination and otomicroscopy. Pre
operative hearing evaluation was done by pure tone audiometry. Myringoplasty was
performed using temporalis fascia and tragal perichondrium in group A and group B
respectively. Follow up was done at 3 weeks, 6 weeks, 3 months and at 6 months post
operatively. During the follow up, patients were assessed for graft uptake and hearing
improvement and the results were compared between both the groups. The results were
as follows: Age of pts was between 15- 60 yrs with majority between 20 to 40yrs. There
were a total of 33 males and 27 females. Right ear was operated in 33 patients and left
ear in 27 patients. A total of 14 cases were operated with presence of bilateral disease
(6:8). Overall graft uptake rate was 85%. Graft uptake rate was 83.33% with
temporalis fascia and 86.66% with tragal perichondrium. Mean improvement in
hearing for temporalis fascia was 9.81 ± 5.10 dB and for tragal perichondrium was 8.42
± 4.10 dB.
Conclusion: It is concluded that graft material does not influence the either graft uptake
or hearing improvement in safe type of CSOM when conductive hearing loss is less than
40 db and in the absence of central pathology and tympanosclerosis.

The injury or damage of some of the parts or whole ossicular chain is concerned with
chronic su
The injury or damage of some of the parts or whole ossicular chain is concerned with
chronic suppurative otitis media involving active mucosaldisease.There are no precise or clear
cut elements which may specify or show that in case of safe CSOM , ossicular erosion is present
preoperatively. So, this research has been conducted to look into the pattern of ossicular erosion
in chronic otitis media in both the cases mucosal and squamosal disease.
ppurative otitis media involving active mucosaldisease.There are no precise or clear
cut elements which may specify or show that in case of safe CSOM , ossicular erosion is present
preoperatively. So, this research has been conducted to look into the pattern of ossicular erosion
in chronic otitis media in both the cases mucosal and squamosal disease.