Keywords : CSOM
Clinico-bacteriological and antibiotic drug resistance profile of Chronic Otitis Media: Mucosal disease, at a tertiary care hospital in rural Haryana: A retrospective observational study
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 6, Pages 648-655
Background: Objectives: To determine the microbiological profile and antimicrobial susceptibility pattern of bacterial isolates from aural swabs in patients with CSOM. Materials and Methods: A total of 142 patients of CSOM with unilateral or bilateral ear discharge who attended the outpatient department from March 2020 to November 2020 were included. Results: Among 142 patients included in the study, most common age group was 11-20 years. CSOM was found to be more common in females (56.33%) than in males (43.66%). The most common bacterial isolate was Pseudomonas aeruginosa (45.8%) followed by Staphylococcus aureus (30.5%), Proteus mirabilis (13.8%), Acinetobacter baumannii (2.7%), Klebsiella pneumonia, Micrococcus, E. Coli, Citrobacter and Providentia species. Pseudomonas aeruginosa was found to have maximum sensitivity to Polymyxin B (87.8%) and least sensitive to amoxicillin (15.1%). Among Staphylococcus aureus (87% MRSA and 13% MSSA) maximum isolates were sensitive to piperacillin+tazobactam (90.9%) and least sensitive to amoxicillin (13.6%).
Audiometric Assessment Of Hearing Status In Patients After Myringoplasty
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 123-134
Introduction :Chronic suppurative otitis media (CSOM)is a middle ear disease with permanent abnormality of pars tensa or pars flacida resulting in discharge and hearing loss. Hearing loss is mostly conductive in nature.Pure tone audiometry is a subjective measurement of hearing threshold level. It is done preoperatively to know the degree and type of hearing loss and postoperatively to measure the audiological gain.
Objective:to assess hearing status of patients after myringoplasty using pure tone audiometer.
Methods:The study was done on 100 patients suffering from CSOM active mucosal type. Patient parameters including age, size and site of the perforation were evaluated. Hearing levels were assessed as the mean air conduction (AC), and air-bone gap (ABG) at 500, 1000, and 2000 Hz, and their relation with aforementioned parameters were analyzed.Myringoplasty was performed and then patients were followed up for three months and on each visit hearing status was assessed by Pure Tone Audiometry.
Results:At the end of the study it was found that mostofthe patients were in younger age group 15-25 years(60%).The commonest site was central perforation (88%) with large size perforation being (51%). The pre and post operativeaudiological difference found to be significant with average audiological gain more than 10dB and overall hearing improvement was 86% at 1 month and 93% at the end of 2 and 3 month.
Conclusions:There was a significant audiological improvement following myringoplastywith postauricular route using temporalis fascia graft via underlay technique in patients of mucosal type of chronic suppurative otitis media.However no significant difference was found in the audiological gain when compared to different age,site and size of perforation.
A STUDY OF HEARING IMPROVEMENT AFTER TYMPANOPLASTY IN PATIENTS OF CSOM
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 983-988
one of the primary causes of hearing loss. The current study was designed to evaluate the
improvement in hearing after tympanoplasty in CSOM patients who presented to a tertiary care
teaching hospital.
MaterialsAnd Methods: The current study was a prospective observational study that took
place in the department of ENT at Viswarabharathi Medical College and General Hospital
from March 2019 to February 2020. The study included 50 individuals who were clinically
diagnosed with chronic suppurative otitis media Tubotympanic type illness. Pre-operatively,
pure tone audiometry was performed, and hearing loss and the mean AB Gap were recorded.
Tympanoplasty type 1 was done with or without mastoidectomy. After 6 weeks, all of these
patients were followed up on and Pure tone audiometry was done. The outcomes of hearing
loss and mean AB Gap were compared to pre-operative data.
A Comparative Study of graft uptake and hearing improvement following Myringoplasty using Temporalis fascia and Tragal perichondrium in mucosal type of COM
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 1599-1611
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.
Change in findings of culture and sensitivity data if any in chronic otitis media during COVID pandemic
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 2, Pages 1067-1073
Background: Chronic otitis media is an important cause of morbidity affecting all ages leading to variety of complications which has major impact on the patients and more so in Covid pandemic. Study to see the change in findings of culture and sensitivity data in chronic Otitis media during Covid pandemic and hence modify the treatment plan.
Aims: To study the bacteriology associated with the chronic otitis media and study any change in findings of bacteriology of chronic otitis media during COVID pandemic.
Subjects and methods: The retrospective study was done. The culture and sensitivity data during Covid pandemic was collected from Jan 2020 to Jan 2021 from ENT centre and their analysis and interpretation done according to age, types of culture and their sensitivity.
Result: In the total 100 cases of culture and sensitivity results during pandemic, pseudomonas aeruginosa was the most common organism isolated and showed highest sensitivity towards piperacillin/tazobactam and polymyxin B. Staphylococcus aureus was second most common which showed highest sensitivity towards linezolid and teicoplanin. Both showed lowest sensitivity towards ciprofloxacin. There was no change found in the bacteriology culture during the Covid pandemic which was compared from available literature.
Conclusion: the change in the findings of culture and study of chronic otitis media based on the study done shows almost no difference with the pre-pandemic times. But high antibiotic resistance implicates the careful use of antibiotics in treatment and avoiding empirical method of treatment.