scholarly journals An increase in cases of complicated chronic otitis media: an indirect impact of COVID pandemic

Author(s):  
Faizah A. L. Deva

<p><strong>Background:</strong> Chronic otitis media is the most common disease dealt by an otologist, the cases of complication of which are remarkably low. The use of antibiotics and mastoidectomies have resulted in the fall of the fatal complications. COVID-19 pandemic called for restrictions which lead to medical care delay.</p><p><strong>Methods:</strong> This study was conducted in the department of otolaryngology of GMC and associated hospitals, Jammu from June 2020 and May 2021. The data was retrospectively collected the data from March 2018 to June 2020. The study group included the patients diagnosed with Chronic suppurative otitis media (CSOM) on otoscopy and the patients with complications of CSOM were evaluated for the symptoms of complication, type of complication, bacteriology, treatment and hospital stay.</p><p><strong>Results:</strong> The 38 (7.5%) patients among these were diagnosed with one or other complication, out of which 29 (76.3%) cases occurred during the COVID pandemic. The extra-cranial complications were more common and young to middle age group was more commonly involved.</p><p><strong>Conclusions:</strong> COM is a common otological disease, the occurrence of which should not be taken lightly. Without timely and accurate treatment, the complications ensue which are difficult to treat and require expertise.</p>

1970 ◽  
Vol 15 (2) ◽  
pp. 50-54
Author(s):  
Syed Hasan Imam Al-Masum ◽  
Md Arif Hossain Bhuiyan ◽  
Md Abu Yusuf Fakir

Objective: To study the clinical, audiological and radiological characteristics along with the management outcome of chronic otitis media with effusion. Setting: Department of Otolaryngology & Head - Neck Surgery, Dhaka Shishu Hospital and Apollo Hospital's Dhaka, Bangladesh. Materials and Methods: This study included three hundred and thirty patients of chronic Otitis media with effusion that have been treated in the department of Otolaryngology and Head-Neck Surgery, at Dhaka Shishu Hospital and Apollo Hospitals, Dhaka from January, 2007 to July, 2008. The data of patients included age, sex, presenting symptoms and signs, preoperative investigations like pure tone audiometry (PTA) and Impedance test, operation notes, complications of surgery and state at follow up. Results: This study included 198 males and 132 females. 222 patients (67.27%) were in the age group of 2-5 years. Main presenting symptom was fullness of the ear (50.30%) and main presenting sign was dull eardrum (72.18%). Turning fork test and PTA have been done in the age group of 7-10 years. In 166(59.30%) patients Impedence was type B. 222 (66.69%) patients have been cured with medical treatment. 69(20.90%) patients underwent grommet insertion as medical treatment has been failed in those patients. Two patients developed postoperative chronic suppurative otitis media with central perforation and one patient developed thinned tympanic membranes that have been treated conservatively. Conclusion: Chronic otitis media with effusion is usually not a threat to life but result in complications. As long as fluid is present in the middle ear, hearing will be affected. Hearing problems can interfere with language development in children. Any fluid that lasts longer than 3 months should be treated surgically. Keywords: Otitis Media with effusion; myringotomy; audiometry. DOI: 10.3329/bjo.v15i2.5057 Bangladesh J Otorhinolaryngol 2009; 15(2): 50-54


2021 ◽  
Vol 9 (03) ◽  
pp. 122-126
Author(s):  
Ali Abdulridha Atiyah ◽  
◽  
Nada Saadi Majeed ◽  

Background:Otitis media is an inflammation of part or all of the mucoperiosteal lining of the middle ear cleft. It can be acute, subacute and chronic otitis media infection. Septal deviation has got many unwanted changes such as: nasal obstruction, mucosal changes. Methodology:A descriptive clinical study, carried out on adult patients consulting ENT department at medical city. Those patients have a unilateral chronic suppurative otitis media. Results:The unilateral CSOM can affect any age group, with a slightly higher prevalence in the age group (21-30) year forming 29% of the total patients.Male to female ratio was 1.2:1. Eighty-nine patients presented with aural discharge. Patients with tubotympanic having only perforation and associated with septal deviation forming 68.1% of the patients. Patients with atticoantral having only perforation and associated with septal deviation 63.2% of patients. Conclusion: Unilateral chronic suppurative otitis media can affect all age group and both sexes. The tubotympanic type is mor prevalent. Nasal septal deviation is commonly found in patients with unilateral chronic suppurative otitis media.


2019 ◽  
Vol 7 (2) ◽  
pp. 17
Author(s):  
Yalda Jabbari Moghaddam ◽  
Farnaz Chalabianloo

Background and Objectives: Chronic otitis media is considered a common disease in our region. There are various methods for evaluation of chronic suppurative otitis media including otoscopy, CT scan, X-ray, and MRI. Nowadays, computed tomography or CT scan is used as the selected method to investigate the temporal bone. This study aims to collect the intraoperative findings and compare them with preoperative reports of temporal bone CT scans. Materials and Methods: The patients’ data with chronic otitis media who were reviewed tomographically, hospitalized and operated between 2012 and 2014 in Tabriz Sina Hospital by only one otolarynologist included in this study collected. Results: The most common lesion based on the highest frequency and percentage is Tympanosclerosis. 21.4 percent of patients whom Tympanosclerosis were not diagnosed preoperatively, found during the surgery. 78.9 And 21.1 percent of bone erosions have been diagnosed by CT scan and by direct vision, respectively. Conclusion: Although preoperative CT of Middle ear lesions is useful for surgery planning but some lesion may not be completely diagnosed by CT scan and intraoperative assessment of surgical field is crucial.


Author(s):  
Sudhakar Rao M. S. ◽  
Navneeth T. P.

<p class="abstract"><strong>Background:</strong> Chronic otitis media is one of the common infections seen in pediatric age group. The most widely recognized route of infection is via the eustachian tube. The inflammation of the pharyngeal end of the eustachian tube may prevent gas exchange, leading to lowering of the middle ear pressure and predisposes to aspiration of nasopharyngeal microbes into the middle ear cleft.</p><p class="abstract"><strong>Methods:</strong> Eighty (80) cases of clinically diagnosed chronic otitis media among pediatric age group of both sexes selected on simple random basis were included in this study. Swabs from both ears and throat were taken and the samples were sent under strict aseptic conditions for culture and sensitivity testing.  </p><p class="abstract"><strong>Results:</strong> The mean age of patients was 6.1years and the frequency of chronic otitis media was maximum in 1-5 years age group. Male to female ratio was 1.6:1.The most frequent organism isolated was <em>S. Aureus</em> followed by <em>Psuedomonas</em>. The ear swab and throat swab findings showed positive relationship (p&lt;0.05) for the common organisms i.e., <em>S. Aureus</em>, <em>pseudomonas</em> and <em>Streptococcus pyogenes</em> respectively, thus suggesting a common etiological agent. Psuedomonal infection was found to be associated with large perforation in tympanic membrane.</p><p class="abstract"><strong>Conclusions:</strong> The pathology in bilateral ear disease is central i.e., throat. Treatment in these cases is focused on selected drug with optimum dose and calculated regimen of treatment completely, thus reducing the morbidity of loss of physiological function of the ear and the grave complications involved.</p><p> </p>


Author(s):  
Mahesh B Mawale ◽  
Abhaykumar Kuthe ◽  
Anupama M Mawale ◽  
Sandeep W Dahake

The prevalence rate of chronic suppurative otitis media is high and its treatment continues to be a challenge for the otorhinolaryngologists. Due to middle ear infection, there may be pain, hearing loss and spontaneous rupture of the eardrum which results in perforation. Infections can cause a hole in the eardrum as a side effect of otitis media. The patients suffering from ear perforation or having a hole in eardrum require preventing entry of water in the ear. This article describes the development of ear cap using additive manufacturing and TRIZ (a collaborative tool) to prevent the entry of water in the ear during chronic otitis media.


2021 ◽  
pp. 73-75
Author(s):  
Pasunuti Shravya ◽  
Jyothi Swarup ◽  
Vigeshwar RK

Background: Chronic otitis media is an inammatory process in middle ear cleft which is treated by a common otological procedure tympanoplasty to reconstruct the tympanic membrane and to restore sound-conducting mechanism. Rigid endoscope in transcanal interlay tympanoplasty has signicant advantage as it provides magnied, and wide angle view, with better success rate and postoperative hearing gain. The Aims and objectives were to assess the outcome of endoscopic interlay tympanoplasty, in terms of graft uptake, hearing improvement and rate of complications in cases of inactive mucosal chronic suppurative otitis media. Methods: This prospective study was conducted for 1 year at our institution in 50 patients having conductive hearing loss with dry, central perforation. All patients underwent transcanal endoscopic interlay tympanoplasty and were followed up for 3months to determine the graft uptake, hearing improvement and rate of complications. Results: Graft uptake rate in the present study was found to be 98% with residual perforation as a complication in 2% patients and no other complications were encountered. Post operatively air bone gap (ABG) after 12 weeks found to be < 20 dB ABG in 84% patients. Conclusion: Endoscopic interlay tympanoplasty is a effective method with high success rate both in terms of graft uptake as well as post operative hearing improvement and can be implemented in all cases of inactive mucosal COM.


2019 ◽  
pp. 014556131987391
Author(s):  
Agnieszka Wiatr ◽  
Katarzyna Swiezy ◽  
Jacek Skladzien ◽  
Maciej Wiatr

Objective: Chronic otitis media is a heterogeneous disorder. Chronic suppurative otitis media with cholesteatoma and, to a lesser extent, chronic otitis media with granulation lead to the destruction of bone structures within the middle ear. Bone loss may appear in the prominence of the horizontal semicircular canals and the bony canal of the facial nerve. The inflammatory process may spread to the bony labyrinth of the sigmoidal sinuses and the cranial cavities. Materials and Methods: The analysis comprised the examination of fragments of auditory ossicles removed during surgery in 21 patients with various types of chronic inflammation of the middle ear. The purpose of this study was to evaluate the usefulness of scanning electron microscopy in evaluating the erosion of middle ear ossicles in different types of chronic otitis media. Images captured at various magnifications were used for the best possible illustration of the observed lesions in bone tissue. Results: The observed lesions and the degree of bone surface damage were dependent on the type of chronic inflammation of the middle ear. The largest destructive changes in the ossicular chain were observed in chronic otitis media with cholesteatoma; smaller changes were observed in chronic otitis media with granulation. Conclusion: In the case of damage to the ossicles inflicted by inflammation, the use of a modeled bone block made of a temporal bone taken from outside the tympanic cavity or a biomaterial prosthesis is a good choice in ossiculoplasty.


2020 ◽  
Vol 27 (1) ◽  
pp. 70-80
Author(s):  
Abulajiang Tuoheti ◽  
Xingzhi Gu ◽  
Xiuqin Cheng ◽  
Hua Zhang

Compromised TLR-mediated chronic inflammation contributes to bacterial infection-caused chronic suppurative otitis media, but the mechanisms are unclear. The present study examined the expression status of nuclear erythroid 2-related factor 2 (Nrf2) and TLRs in human middle-ear mucosae tissues collected from patients with chronic suppurative otitis media, chronic otitis media and non-otitis media, and found that Nrf2 was high-expressed, whereas TLR4, instead of other TLRs, was low expressed in chronic suppurative otitis media compared to chronic otitis media and non-chronic otitis media groups. Consistently, inflammatory cytokines were significantly up-regulated in the chronic suppurative otitis media group, instead of the chronic otitis media and non-chronic otitis media groups. Next, LPS-induced acute otitis media and chronic suppurative otitis media models in mice were established, and high levels of inflammatory cytokines were sustained in the mucosae tissues of chronic suppurative otitis media mice compared to the non-otitis media and acute otitis media groups. Interestingly, continuous low-dose LPS stimulation promoted Nrf2 expression, but decreased TLR4 levels in chronic suppurative otitis media mice mucosae. In addition, knock-down of Nrf2 increased TLR4 expression levels in chronic suppurative otitis media mice, and both Nrf2 ablation and TLR4 overexpression inhibited the pro-inflammatory cytokine expression in chronic suppurative otitis media. Finally, we found that both Nrf2 overexpression and TLR4 deficiency promoted chronic inflammation in LPS-induced acute otitis media mice models. Taken together, knock-down of Nrf2 reversed chronic inflammation to attenuate chronic suppurative otitis media by up-regulating TLR4.


Pathogens ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 224 ◽  
Author(s):  
Nicola Malagutti ◽  
John Charles Rotondo ◽  
Luca Cerritelli ◽  
Claudio Melchiorri ◽  
Monica De Mattei ◽  
...  

Background. Previous studies reported human papillomaviruses (HPVs) in middle ear tumors, whereas these viruses have been poorly investigated in chronic inflammatory middle ear diseases. We investigated HPVs in non-tumor middle ear diseases, including chronic otitis media (COM). Methods. COM specimens (n = 52), including chronic suppurative otitis media (CSOM) (n =38) and cholesteatoma (COMC) (n = 14), as well as normal middle ear (NME) specimens (n = 56) were analyzed. HPV sequences and DNA loads were analyzed by quantitative-PCR. HPV genotyping was performed by direct sequencing. Results. HPV DNA was detected in 23% (12/52) of COM and in 30.4% (17/56) of NME (p > 0.05). Specifically, HPV DNA sequences were found in 26.3% (10/38) of CSOM and in 14.3% (2/14) of COMC (p > 0.05). Interestingly, the HPV DNA load was higher in COMC (mean 7.47 copy/cell) than in CSOM (mean 1.02 copy/cell) and NME (mean 1.18 copy/cell) (P = 0.03 and P = 0.017 versus CSOM and NME, respectively). HPV16 and HPV18 were the main genotypes detected in COMC, CSOM and NME. Conclusions. These data suggest that HPV may infect the middle ear mucosa, whereas HPV-positive COMCs are associated with higher viral DNA loads as compared to NME.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Ercan Kaya ◽  
Ilknur Dag ◽  
Armagan Incesulu ◽  
Melek Kezban Gurbuz ◽  
Mustafa Acar ◽  
...  

Objective. Biofilms have been shown to play a major role in the pathogenesis of otolaryngologic infections. However, very limited studies have been undertaken to demonstrate the presence of biofilms in tissues from patients with chronic otitis media (COM) with or without cholesteatoma. Our objective is to study the presence of biofilms in humans with chronic suppurative and nonsuppurative otitis media and cholesteatoma.Study Design. In all, 102 tissue specimens (middle ear, mastoid tissue, and ossicle samples) were collected during surgery from 34 patients.Methods. The samples were processed for the investigation of biofilms by scanning electron microscopy (SEM).Results. Our research supports the hypothesis in which biofilms are involved in chronic suppurative otitis media, cholesteatoma, and, to a lesser degree, chronic nonsuppurative otitis media. There were higher rates in hypertrophic and granulated tissue samples than in normal mucosa. In addition, the presence of biofilms was significantly higher in the middle ear mucosa compared with the mastoid and ossicle samples.Conclusion. In the clinic, the careful use of topical or systemic antimicrobials is essential, and, during surgery, hypertrophic tissue must be carefully removed from normal tissue.


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