European Journal of Molecular & Clinical Medicine

BACKGROUND AND OBJECTIVES:
Untill now, HRCT Temporal bone is preffered imaging modality for middle ear pathology prior to surgical exploration of ears with cholesteatoma. But it lacks specificity. The aim of this study is to understand the role of DWI (Diifusion Weighted Images) in detection, evaluation and diagnosis of primary and recurrent middle ear cholesteatoma and to correlate with intraoperative findings.
METHODS
A prospective study in which 30 patients who presented to the Department of  ENT and diagnosed to have cholesteatoma by clinical , otoscopic and audiometry  examination were subjected to HRCT temporal bone followed by DWI- MRI screening of the temporal bone and data was analyzed using standard statistical methods.
RESULTS
DWI- MRI is having a high sensitivity for identification of the disease at most of the sites within the temporal bone except for the incus , stapes and facial nerve canal region .
CONCLUSION
DWI- MRI scan acts as an excellent preoperative as well as postoperative  imaging modality for diagnosis of primary and recurrent middle ear cholesteatoma .

The current study aims at bacterial and fungal etiology of Cholesteatoma in patients attending tertiary care hospital. Cholesteatoma is an abnormal, noncancerous skin growth that can develop in the middle section of ear, behind the eardrum. It is a complication of chronic suppurative otitis media. With the informed consent, 70 patients with Cholesteatoma were included; 42 (60%) were male and 28 (40%) were female, and the mean age was 11-50 years. Materials and methods- Cholesteatoma sac and 2 preoperative swabs were collected from ENT OPD patients complaining of earache and discharge. Results- Out of 70 patients, 28 were sterile samples, 40 (41.7%) showed aerobic bacteria and 2 (1.3%) had fungal etiologies. Conclusion- Gram negative pathogen forms most aural swabs and Cholesteatoma sacs. Pseudomonas aeruginosa was the predominant isolate 18(25.7%), followed by Staphylococcus aureus
11(15.7%) and their antimicrobial susceptibility testing was done. Though the treatment of Cholesteatoma is surgery but to avoid recurrence, the use of proper antibiotics by knowing the antibiogram will lead to a decrease in the prevalence of microbial growth and recurrence of Cholesteatoma.

Introduction: HRСT Temporal bone in unsafe CSOM саn рrоvide exсellent detаils оf temроrаl bоne аnаtоmy, its соngenitаl vаriаtiоns, lосаtiоn аnd extent оf diseаse, аsymрtоmаtiс соmрliсаtiоns аnd degree оf bоne destruсtiоn. It соnfirms оtоsсорiс findings tо greаter extent, сleаr mаny сliniсаl dоubts аnd helрs in determining surgiсаl effiсасy when surgery will be neсessаry аnd аlsо fоr рlаnning the аррrоасh fоr surgery.
Aim: To assess the usefulness of HRCT imaging of temporal bone in cases of unsafe chronic suppurative otitis media and to describe the status of the disease in unsafe chronic suppurative otitis media.
Material and Methods: Total 40 patients with clinical diagnosis of unsafe CSOM were included in the study and underwent HRCT using Siemens Sоmаtоm Sсорe 16 sliсe СT mасhine as per standard protocol. Each HRCT was analysed for presence of soft tissue density in middle ear and mastoid cavity and status of ossicles, mastoid cavity, scutum, lateral semicircular canal, cochlea, facial nerve canal, external auditory canal, tegmen tymphani and sinus plate.
Results: Maximum numbers of patients were in age group of 21 to 30 (35%) with male to female ratio of 2.6:1. Most common chief complaint was otorrhoea (90%) and hearing loss (45%). Mоst соmmоn ossicle eroded wаs incus (65%) and scutum erosion noted in 55% cases.
Conclusion: HRСT is useful fоr diаgnоsis, surgiсаl рlаnning аnd mаnаgement оf temроrаl bоne раthоlоgies. Рreорerаtive СT sсаn is benefiсiаl аnd соntributоry in relаtiоn tо diаgnоsis аnd deсisiоn-mаking in indiсаting орerаtiоn tо раtients with СSОM аnd imрrоves the suссess rаte оf сhоlesteаtоmа surgeries. It serves аs rоаd mар tо аssist the surgeоn during surgery.

Objectives: Ear is prone to various kinds of infections out of which chronic otitis media is
the most common type. Squamosal disease of chronic otitis media is associated with
cholesteatoma and is prone to secondary infections especially by aerobic bacteria. This study
was done to assess culture and sensitivity of preoperative aural swab and swab from purulent
material from mastoid with cholesteatoma obtained intraoperatively during surgery.
Comparative study has been made.
Methods: 100 Cases of chronic superlative otitis media of squamosal type with clinical
diagnosis of cholesteatoma who were admitted and underwent mastoidectomy operation in
tertiary ENT care centre during the period from November 2018-September 2020 were
studied. Pus obtained during aural toilet was sent for bacteriological and antibiotic sensitivity
studies and intraoperatively obtained cholesteatoma matrix sent for bacteriological study.
Results: Polymicrobial floras were observed both in pre-operative and intra-operative
cultures. Staphylococcus aureus and Pseudomonas aeruginosa were the most common
pathogens identified.
Conclusion: This study might have a role in facilitating use of culture guided antibiotic
therapy to improve postoperative outcome and also to prevent recurrences, eventually helping
in giving disease free ear to the patient.