CHRONIC SUPPURATIVE OTITIS MEDIA “UNSAFE TYPE”: AN EXPERIENCE AT A TERTIARY CARE HOSPITAL

Abstract

Objective:

To evaluate the clinical characteristics, examination findings, complications and hearing in patients with unsafe type of chronic suppurative otitis media (CSOM) in a tertiary care hospital.

Materials and Methods:

This prospective clinical study was conducted in Department of Otorhinolaryngology & HNS, B.P.Koirala Institute of Health Sciences Dharan, from January 2007 to January 2008. All patients with unsafe type of CSOM were assessed with clinical history, otoscopic examination, tunning fork test, pure tone audiometry, radiological investigations and examination under microscope and findings were noted in proforma.

Results:

Total 118 patients of unsafe type of CSOM with mean age of 20.4 years were included. Maximum numbers of patients (88.1%) were from terai region. Eighty nine patients (75.4%) complained of hearing loss and almost all (99.2%) had aural discharge. Nineteen patients (16.1%) presented with associated complications. On examination, 54(45.7%) had tympanic membrane perforation, while 59 (50%) had retraction pocket. Hundred eleven patients (94%) had hearing loss, mainly moderate degree (29.7%), conductive type (75.4%). Forty five patients had both cholesteatoma and granulation tissue. The common site of pathology was posterior superior quadrant (PSQ). There was high incidence of cholesteatoma when lesion was at PSQ and attic region while granulation was common at external auditory canal. (p= 0.046)

Conclusion:

Unsafe type of CSOM is common in younger population that presents with ear discharge and variable degree of conductive hearing loss. Retraction pocket and tympanic membrane perforation are the main otoscopic findings and PSQ is the most common site of pathology.

Keywords: chronic suppurative otitis media, Complication, Unsafe