Author(s): Venugopal Mohankumar1, Narendrakumar Veerasigamani2
Chronic Suppurative Otitis Media (CSOM) is the chronic inflammation of the middle ear cleft mucosa, which is characterised by irreversible changes in it with a history of ear discharge for more than 3 months through a permanent tympanic membrane defect. Chronic suppurative otitis media is of two types tubotympanic (mucosal) and atticoantral (squamous). Tubotympanic type (mucosal) is mainly due to infection from the oropharynx and the nasopharynx, which travels into the middle ear via the eustachian tube, whereas atticoantral type (squamous type) is due to cholesteatomatous lesions. The prevalence of CSOM was 4.1 percent (3.1%- unilateral and 1.0% bilateral disease). Both otitis media and sinusitis are the most common pediatric diagnoses and they share many common characteristics. The aim of the study is to prove focal sepsis of chronic otitis media, tubotympanic type sinusitis and there is an improvement in middle ear mucosal disease status after functional endoscopic sinus surgery.
MATERIALS AND METHODS
50 patients in the age groups of 20-40 years chronic otitis media tubotympanic type attending outpatient department were identified and screened for evidence of focal sepsis in paranasal sinus by diagnostic nasal endoscopy and computed tomography. Then, nasal surgery was done to clear sinusitis and middle ear mucosal disease status assessed for improvement and statistically assessed.
Deviated nasal septum (33%) was the most common pathology among the study population. Majority (48%) of them had mucopurulent type of ear discharge. The CT findings of the paranasal sinuses revealed that 56% of the study population had grade I type of involvement of the PNS. 44% of the patients had a large central perforation. About 84% of patients had improved mucosal status after treating sinusitis.
There is a strong correlation between tubotympanic types of chronic otitis media with sinusitis. Treating sinusitis gives best results to CSOM patients. DNE and CT scan of paranasal sinuses plays vital role in diagnosis of sinusitis.