scholarly journals Cochlear implantation in the presence of chronic suppurative otitis media

1997 ◽  
Vol 111 (3) ◽  
pp. 228-232 ◽  
Author(s):  
P. R. Axon ◽  
D. J. Mawman ◽  
T. Upile ◽  
R. T. Ramsden

AbstractNine patients are presented who underwent cochlear implantation in the presence of chronic suppurative otitis media. Four had a simple tympanic membrane perforation, four had a pre-existing mastoid cavity and one had cholesteatoma in the ear chosen for implantation. Patients with a simple perforation had a staged procedure with myringoplasty followed by cochlear implantation after an interval of three months. Patients with cholesteatoma or with an unstable mastoid cavity were also staged. A mastoidectomy or revision mastoidectomy was performed with obliteration of the middle ear and mastoid using a superiorly pedicled temporalis muscle flap and blind sac closure of the external meatal skin. After a further six months a second stage procedure was performed to confirm that the middle-ear cleft was healthyand to insert the implant. Patients presenting with a stable mastoid cavity underwent obliteration of the cavity and implantation of the electrode as a one-staged procedure. To date there have been no serious problems such as graft breakdown, recurrence of disease or implant extrusion, and all patients are performing well.

2021 ◽  
Vol 5 (7) ◽  
pp. 647-656
Author(s):  
Ahmad Hifni ◽  
Rian Hasni ◽  
Fiona Widyasari ◽  
Abla Ghanie ◽  
Erial Bahar

Introduction: Chronic suppurative otitis media (CSOM) is a chronic inflammation of the middle ear and mastoid cavity. It is necessary to identify bacterial patterns and antibiotics susceptibility in CSOM. Appropriate administration of antibiotics is essential to treat infection and prevent widespread resistance. Objective: The aim of this study is to compare the pattern of germs and antibiotic susceptibility between CSOM with cholesteatoma and without cholesteatoma. Methods: Observational study with cross-sectional design. Data collection was carried out using medical record data on 102 subjects who underwent middle ear swab and bacterial culture from January to December 2019. Results: From 102 subjects and 122 bacterial culture results. it was found that Pseudomonas aeruginosa (36.1%) was one of the most common organisms to cause CSOM. followed by Staphylococcus haemolyticus. Staphylococcus epidermidis and Staphylococcus aureus. There was a significant difference between the germ pattern and the type of CSOM (p = 0.002). Amikacin. meropenem. gentamicin. cefepime. ciprofloxacin and ceftazidime were found to be the most effective antibiotics for Pseudomonas aeruginosa. The rate of resistance to tigecycline and cefazoline were highest. Age. sex. nutritional status and comorbidities were not factors that significantly influenced the incidence of cholesteatoma in CSOM. Conclusion: There is a significant difference between the germ pattern in both CSOM groups. Patients that show Gram negative have a significant effect on the incidence of CSOM with cholesteatoma.


2021 ◽  
Vol 5 (3) ◽  
pp. 675-684
Author(s):  
Ahmad Hifni ◽  
Rian Hasni ◽  
Fiona Widyasari ◽  
Abla Ghanie ◽  
Erial Bahar

Introduction: Chronic suppurative otitis media (CSOM) is a chronic inflammation of the middle ear and mastoid cavity. It is necessary to identify bacterial patterns and antibiotics susceptibility in CSOM. Appropriate administration of antibiotics is essential to treat infection and prevent widespread resistance. Objective: The aim of this study is to compare the pattern of germs and antibiotic susceptibility between CSOM with cholesteatoma and without cholesteatoma. Methods: Observational study with cross-sectional design. Data collection was carried out using medical record data on 102 subjects who underwent middle ear swab and bacterial culture from January to December 2019. Results: From 102 subjects and 122 bacterial culture results. it was found that Pseudomonas aeruginosa (36.1%) was one of the most common organisms to cause CSOM. followed by Staphylococcus haemolyticus. Staphylococcus epidermidis and Staphylococcus aureus. There was a significant difference between the germ pattern and the type of CSOM (p = 0.002). Amikacin. meropenem. gentamicin. cefepime. ciprofloxacin and ceftazidime were found to be the most effective antibiotics for Pseudomonas aeruginosa. The rate of resistance to tigecycline and cefazoline were highest. Age. sex. nutritional status and comorbidities were not factors that significantly influenced the incidence of cholesteatoma in CSOM. Conclusion: There is a significant difference between the germ pattern in both CSOM groups. Patients that show Gram negative have a significant effect on the incidence of CSOM with cholesteatoma.


2016 ◽  
Vol 54 (10) ◽  
pp. 2538-2546 ◽  
Author(s):  
Michel Neeff ◽  
Kristi Biswas ◽  
Michael Hoggard ◽  
Michael W. Taylor ◽  
Richard Douglas

Chronic suppurative otitis media (CSOM) presents with purulent otorrhea (ear discharge), is characterized by chronic inflammation of the middle ear and mastoid cavity, and contributes to a significant disease burden worldwide. Current antibiotic therapy is guided by swab culture results. In the absence of detailed molecular microbiology studies of CSOM patients, our current understanding of the microbiota of CSOM (and indeed of the healthy ear) remains incomplete. In this prospective study, 24 patients with CSOM were recruited, along with 22 healthy controls. Culture-based techniques and 16S rRNA gene amplicon sequencing were used to profile the bacterial community for each patient. Comparisons between patients with and without cholesteatoma in the middle ear and mastoid cavity were also made. A major finding was that the middle ear of many healthy controls was not sterile, which is contradictory to the results of previous studies. However, sequencing data showed thatStaphylococcus aureus, along with a range of other Gram-positive and Gram-negative organisms, were present in all subgroups of CSOM and healthy controls. Large interpatient variability in the microbiota was observed within each subgroup of CSOM and controls, and there was no bacterial community “signature” which was characteristic of either health or disease. Comparisons of the culture results with the molecular data show that culture-based techniques underestimate the diversity of bacteria found within the ear. This study reports the first detailed examination of bacterial profiles of the ear in healthy controls and patients with CSOM.


Author(s):  
Sapna Chauhan ◽  
Surender

Chronic Suppurative Otitis Media (CSOM) is commonly encountered chronic inflammation of middle ear as well as the mastoid cavity due to dysfunction of Eustachian tube followed by microbial infection. Fungal infection in CSOM is now a major otolarynological problem in India not only in children but in adults too. Excessive use of steroids, antibiotics, cytotoxic chemotherapies and immunosuppressive diseases has increased the incidence of otomycosis in recent years. To define the aetiology of clinically diagnosed otomycosis. To isolate and identify fungal agents and their association with different factors(age, sex, predisposing factors). A total of 100 clinically diagnosed patients of CSOM with suspicion of otomycosis were included in the study. Patients where passing swab is difficult as with canal stenosis were excluded. Samples were taken using sterile swabs and studied for microbial profile. Male to female ratio in study was 1.6:1. The most common fungi isolated in CSOM cases was Aspergillus fumigatus followed by Aspergillus niger. Other fungus isolated were Aspergillus flavus, Penicillium species, Mucor species and Candida species. 04 samples showed mixed growth of Aspergillus species and Candida species. In our study we concluded that Aspergillus complex was most commonly isolated fungi in CSOM cases.


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 ◽  
Vol 15 (6) ◽  
pp. 1426-1428
Author(s):  
W. Javaid ◽  
A. Rashid ◽  
M. U. K. Amin ◽  
T. Khan ◽  
M. Fatima

Background: Cholesteotoma is a benign but destructive lesion leading to ossicular necrosis. Objective: To see the frequency of incus bone erosion on mastoid exploration in chronic suppurative otitis media with middle ear cholesteotoma. Study Design: Cross-sectional descriptive study. Setting: This study was carried out in the Department of ENT Unit-2, Sir Ganga Ram Hospital, Lahore. Duration of Study: Fifteen months months (10th April, 2019 to 9th July, 2020) Sample technique: Non- probability purposive sampling Methods: One hundred and twenty patients were admitted through outpatient department of ENT Unit-2, Sir Ganga Ram Hospital Lahore. Patients were included after fulfilling the inclusion criteria and information was collected on a prescribed proforma. Finally during surgery under general anesthesia, the operative findings were noted to know the incus bone erosion after middle ear cholesteatoma formation in chronic suppurative otitis media. Results: A total number of one hundred and twenty patients of chronic suppurative otitis media with middle ear cholesteatoma were included. Out of which 80 (66.7%) were males and 40 (33.3%) were females(Table 1).The patients shown in table 2 were divided in six age groups (Table 2).Table 3 shows that the procedure of mastoidectomy was performed in 112 patients (93.3%) and modified radial mastoidectomy was performed in 8 patients (6.7%).Incus bone erosion in chronic suppurative otitis media with middle ear cholesteatoma in 102 patients (85%) and 18 patients (15%) have no incus bone erosion (Table 4). Conclusion: Ear discharge was the most common presenting characteristic of chronic suppurative otitis media with cholesteatoma. The majority of the cases had ossicular erosion, with the incus being the most common site of involvement. Males are more likely than females to develop cholesteatoma. Keywords: erosion of incus bone, Mastoid exploration, Chronic suppurative otitis media, Cholesteatoma


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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