Prevalence of Chronic Otitis Media among Undernourished Children

Abstract Objective This study aimed to identify the role of nutrition in the etiology of chronic suppurative otitis media (CSOM) by comparing the prevalence of CSOM between undernourished children with normal children aged between 10 and 12 years. Materials and Methods A total of 200 children aged between 10 and 12 years studying in government schools were selected for the study. All the children underwent a general and detailed ENT examination in addition to nutritional assessment based on body mass index calculation, using World Health Organization (WHO) Child Growth Standards Chart. The children were divided into two groups: Group A and Group B. Group A consisted of 100 children who were malnourished and Group B consisted of 100 children who were normal. The presence of CSOM in the two groups was noted. Results and Observations Of the total 200 children, 112 were boys (56%) and 88 were girls (44%). Of the 112 boys, 22 (19.64%) had CSOM and out of 88 girls, 24 (27.27%) had CSOM. Of the total 46 children found to have CSOM, 35 children (76.1%) belonged to Group A and 11 children (23.9%) belonged to Group B. Conclusion Our study shows that there is a higher prevalence of CSOM among undernourished children than in normal children. High prevalence of CSOM in undernourished children is a preventable health problem that needs health education and active intervention.

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comparison of Efficacy of Topical Ciprofloxacin Ear drops (0.6%) Versus a Combination of Systemic with Topical Ciprofloxacin in Treating Chronically Discharging Ears

Esculapio ◽

10.51273/esc20.2516317 ◽

2020 ◽

Vol 16 (03, july 2020-Septmber 2020) ◽

Author(s):

Sarwat Hassan Syed ◽

Damish Arsalan ◽

Ghulam Murtaza ◽

Mohammad Qamar Nasir ◽

Muhammad Awais Amin ◽

...

Keyword(s):

Combination Therapy ◽

Otitis Media ◽

Chronic Otitis Media ◽

Substantial Variation ◽

Treatment Methods ◽

Group A ◽

Group B ◽

Ear Drops

Objective: To compare the efficacy of topical ciprofloxacin alone, versus a combination therapy ofsystemic with topical ciprofloxacin(0.6%) in achieving dry ears in active mucosal chronic otitis media after two weeks of treatment. Methods: After obtaining permission from ethical committee of Hospital, an over-all of 150 patients (with 75 subjects each, divided into two groups) were included in this study. In Group-A: Topical Ciprofloxacin ear drops (0.6%) 3-4 drops were instilled three times a day, 8 hours apart for 2 weeks. In Group-B: Tab Ciprofloxacin 500mg was given twice a day, 12 hours apart for 14 days along with topical Ciprofloxacin ear drops (0.6%) 3 drops were used thrice a day, 8 hours apart for 14 days. Results: Patients ranged between 15-45 years of age. Mean age of the patients was 30.3±7.4 and 29.2±7.7 years. In group-A, there were 41 males (54.7%) and in group-B 49 males (65.3%). Females were 34 (45.3%) in group-A and 27 (36%) in Group-B. Mean duration of ear discharge was 5.3±1.1 months in group-A while 5.5±1.4 months in Group-B. We could not find any substantial variation among the two group in terms of efficacy (p=0.249). Stratification with regard to age, gender and duration of ear discharge was also carried out. Conclusion: Results of this study showed that topical ciprofloxacin ear drops (0.6%) were equally effective as systemic ciprofloxacin combined with topical ciprofloxacin (0.6%), for treating chronically discharging ears. Keywords: CSOM, ciprofloxacin, nature of discharge

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Efficacy of Acetic Acid Irrigation in Management of Chronic Suppurative Otitis Media “A Prospective Study

10.53350/pjmhs2115103300 ◽

2021 ◽

Vol 15 (10) ◽

pp. 3300-3303

Author(s):

Nasir Riaz ◽

Shakaib Faiz ◽

Danish Hassnain ◽

Ayesha Fayyaz ◽

Tarique Khan ◽

...

Keyword(s):

Acetic Acid ◽

Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media ◽

Acid Versus ◽

Acid Irrigation ◽

Group A ◽

Group B ◽

A Prospective Study ◽

Systemic Antibiotics

Background: Prior to surgical management of chronic suppurative otitis media (CSOM) for the dry ear medical management is necessary. CSOM is a biofilm disease and due to this has antibiotic resistance. The pillar of its treatment included aural cleaning according to standard protocols, application of topical germ free antiseptic and use of antimicrobials. Acetic acid due to its ability in reducing the pH may be effective in reducing the growth of microorganisms. Objective: The aim of the study was to compare the efficacy of irrigation with acetic acid versus systemic antibiotics in CSOM patients. Materials & Methods: A total of 134 patients, who came to the ENT department of Sheikh Zayed Hospital, Lahore between 1st April 2020 to 30th September 2020, who had CSOM, of age 15 to 55 years and both genders were included in the study. The patients were divided randomly into two groups. Group A patients received aural toilets and irrigation with acetic acid and Group B received 500 mg of ciprofloxacin twice a day for 2 weeks. Results: The mean age (in years) of the patients in Group A was 37.45±7.32 and in Group B, it was 37.96±7.57. The efficacy of irrigation with acetic acid versus systemic antibiotics was 89.55% and 68.66% respectively and this difference between the two groups was found to be statistically significant (p=0.003). Conclusion: Irrigation with acetic acid was better than systemic antibiotics in managing patients with CSOM. Key words: Acetic acid, CSOM, Middle ear

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Outcome of underlay versus interlay tympanoplasty in patients with inactive mucosal chronic otitis media with large central perforation: a retrospective comparative study

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20205631 ◽

2020 ◽

Vol 7 (1) ◽

pp. 121

Author(s):

Rajneesh . ◽

Dinesh Valse ◽

Shradha Pawar ◽

Anil Kumar Doddamani

Keyword(s):

Otitis Media ◽

Chronic Otitis Media ◽

Hearing Improvement ◽

Tertiary Referral Hospital ◽

Hospital Department ◽

Central Perforation ◽

Group A ◽

Graft Success ◽

Group B ◽

Retrospective Comparative Study

Background: Aim and objective were to study the outcome of underlay versus interlay tympanoplasty in patients with inactive mucosal chronic otitis media with large central perforations in terms of graft uptake rate and hearing improvement. Methods: The present study was conducted retrospectively on 110 patients of inactive mucosal chronic otitis media with large central perforation, 55 patients selected from each group undergoing underlay or interlay technique in a tertiary referral hospital, Department of ENT, ESIC Kalaburagi, Karnataka, from February 1 2018 to January 31, 2020. Results: Total 110 patients were included in the study. Male:female ratio was 1:2.2. The age group in this study ranged from 13-50 years of age. Preoperative mean air bone gap in groups A and B was 30.28±6.62, and 30.18±6.87 dB and postoperative mean air bone gap was 19.44±7.66 and 15.13±6.3 dB. In both the groups a significant mean reduction in air bone gap was observed. Mean reduction was maximum in group B. Statistically, intergroup difference in reduction in air bone gap was highly significant (p<0.001). Graft success rate being 89.09% and 94.54% in underlay (group A) and interlay (group B) respectively.Conclusions: Interlay is a better technique than underlay in chronic otitis media inactive mucosal disease with large central perforation in terms of hearing improvement and graft uptake.

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Role of Cortical Mastoidectomy in the Management of Mucosal Chronic Suppurative Otitis Media

International Journal of Research and Review ◽

10.52403/ijrr.20210718 ◽

2021 ◽

Vol 8 (7) ◽

pp. 136-141

Author(s):

Sumit Sharma ◽

Chhavi Gupta ◽

Richa Singh

Keyword(s):

Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Hearing Improvement ◽

Suppurative Otitis Media ◽

Type 1 Tympanoplasty ◽

Cortical Mastoidectomy ◽

Significant Difference ◽

Group A ◽

Group B

This is a comparative study done to evaluate outcome of type 1 Tympanoplasty with and without mastoidectomy in terms of hearing improvement and graft uptake. This is a prospective study done in 100 patients at a tertiary care referral centre during November 2018 to march 2020. Patients were divided in two groups, Group A consists of 50 patients in whom type 1 Tympanoplasty was done and in Group B 50 patients were there who had undergone Type 1 Tympanoplasty with cortical mastoidectomy. Patients were evaluated postoperatively at 2nd wk, 4th wk, 2nd month and 3rd month for graft uptake, disease clearance, and hearing improvement. PTA was done at 3rd month postoperatively. In our study we observed graft uptake in 94% of patients in Group A as compared to 98% of patients in Group B and in terms of hearing improvement there is not much difference in both the groups i.e. in Group A it is 13.996 ± 4.235 while in Group B it is 14.172 ± 5.381 P value is 1 which means there is no statistically significant difference in two groups. Though better results were observed for cortical mastoidectomy with Type 1 Tympanoplasty than Type 1 Tympanoplasty alone but the difference was insignificant. Keywords: Cortical Mastoidectomy; Mucosal Chronic Suppurative Otitis Media; CSOM.

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Comparative study of tympanoplasty type I using periosteum versus tragal cartilage with perichondrium

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00100-1 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Mohamed M. Elmoursy ◽

Mahmoud M. Elbahrawy

Keyword(s):

Comparative Study ◽

Otitis Media ◽

Type I ◽

Suppurative Otitis Media ◽

Hearing Results ◽

Cartilage Grafts ◽

Significant Difference ◽

Group A ◽

Group B ◽

Grafting Materials

Abstract Background Various grafting materials and different techniques have been used for myringoplasty. The aim of the study was to compare the result of tympanoplasty in patients with safe-type chronic suppurative otitis media using periosteum versus tragal cartilage with perichondrium grafts through pre- and postoperative clinical and audiological evaluation. Results There was statistically significant difference for mean air-bone gap for group A (23.4 dB ± 0.03 SD) when compared to group B (19.4 dB ± 4.2 SD) with P value 0.103. Also, there was statistically significant difference in the hearing gain in group A after 6 months (25.53 dB ± 6.26 SD) when compared to group B (19.63 dB ± 9.76 SD) and the P value was 0.003. Graft taken was superior in the periosteal group (95%), compared to the cartilage grafts (90%). Conclusion Tympanoplasty with periosteal graft showed better hearing results and high rates of graft taken than tragal cartilage grafts.

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Assessment of the outcome of myringoplasty with cortical mastoidectomy in dry and wet mucosal type of chronic otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20204621 ◽

2020 ◽

Vol 6 (11) ◽

pp. 2001

Author(s):

Sreeshma Balan ◽

Prakash M. D.

Keyword(s):

Success Rate ◽

Otitis Media ◽

Statistical Significance ◽

Chronic Otitis Media ◽

P Value ◽

Hearing Improvement ◽

Cortical Mastoidectomy ◽

Significant Difference ◽

Group A ◽

Group B

Background: Chronic otitis media (COM) is an inflammatory process in the middle ear space that results in long-term changes in the tympanic membrane including atelectasis, dimeric-membrane formation, perforation, tympanosclerosis, retraction pocket or cholesteatoma. COM can be classified into healed, inactive (mucosal or squamosal), active (mucosal or squamosal). Myringoplasty is tympanoplasty without ossicular reconstruction. Cortical mastoidectomy is usually accompanied by tympanoplasty. Aim was to assess and compare the efficacy of myringoplasty with cortical mastoidectomy in dry and wet mucosal type of COM, in terms of graft uptake and hearing improvement.Methods: A prospective study, where 30 patients each of wet and dry mucosal-type COM were included. Patients underwent myringoplasty with cortical mastoidectomy. All were followed up for 6 months, both the groups were statistically compared. Results: In our study, mean age of patients in group A (wet COM) was 34.13 years and group B (dry COM) was 33.36 years. Group A had success rate of 90% and group B had success rate of 86.6%. There was no statistical significance (p value- 0.53) on comparing both groups with respect to graft uptake. There was significant hearing improvement post-operatively in both the groups (p<0.05). However, there was no significant difference between the groups (p value- 0.66). This shows that presence of discharge at the time of surgery does not interfere with the results of cortical mastoidectomy with myringoplasty.Conclusions: We conclude that, there is good outcome in both wet and dry COM following myringoplasty with cortical mastoidectomy with respect to graft uptake and hearing improvement.

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Role of Cortical Mastoidectomy in the Management of Safe Chronic Otitis Media

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v18i1.35181 ◽

2020 ◽

Vol 18 (1) ◽

pp. 44-48

Author(s):

Lok Ram Verma ◽

Dhundi Raj Paudel

Keyword(s):

Otitis Media ◽

Chronic Otitis Media ◽

Inactive Disease ◽

Type I ◽

Hearing Improvement ◽

Beneficial Effects ◽

Cortical Mastoidectomy ◽

Group A ◽

Group B

Introduction: Role of cortical mastoidectomy in tympanoplasty for Chronic Otitis Media Mucosal inactive disease is controversial. Some arguments are in favor and suggest that cortical mastoidectomy increases the air reservoir in the mastoid and also help in achieving the patency of aditus but others believe that the ingrowths of squamous epithelium, potential for injury to the inner ear structures and facial nerve during mastoid surgery outweighs the beneficial effects on tympanic membrane healing. Aims: To assess the hearing improvement and graft uptake in patients undergoing Tympanoplasty and Tympano-mastoidectomy in chronic otitis media mucosal inactive disease. Methods: This was a comparative study comprises of 50 patients with Chronic Otitis Media Mucosal inactive ear, conducted in the patients attending the department of ENT in NGMC teaching hospital from Nov 2017 to May 2019. All cases were operated during a period of one half year. 25 patients were selected for tympanoplasty (Group A) and 25 patients were selected for Tympanoplasty with cortical mastoidectomy (Group B). Results: There were 14(28%) male and 36(72%) female, with mean age of 28. 36 years, ranging from minimum of 13 years to maximum 56 years. The postoperative audiograms were recorded after 3 months. Type I tympanoplasty with cortical mastoidectomy has better graft uptake (96%) as compared to without mastoidectomy (84%). Post-operative hearing improvement is almost equal in tympano-mastoidectomy (13.24 dB) and tympanoplasty (13.04 dB). Conclusion: Post-operative hearing gain almost equal in both study group but graft uptake was better with tympano-mastoidectomy then tympanoplasty alone in present study.

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An observational study of endoscopic versus microscopic type I tympanoplasty in tubotympanic chronic otitis media in a tertiary health care centre

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20210536 ◽

2021 ◽

Vol 7 (3) ◽

pp. 434

Author(s):

Amrita Chowdhury ◽

Shatabdi Das

Keyword(s):

Observational Study ◽

Hospital Stay ◽

Otitis Media ◽

Chronic Otitis Media ◽

Type I ◽

Advantages And Disadvantages ◽

Type 1 Tympanoplasty ◽

Group A ◽

Group B

Background: Chronic otitis media (COM) is a widespread disease in the developing countries. It is treated by tympanoplasty, traditionally performed with the microscope which limits the visual field in the deep recesses of the middle ear, especially in narrow external auditory canal. Using endoscope has minimised these difficulties by providing a wide field view with angled magnification, reducing the duration of surgery. The advantages and disadvantages of both techniques is evaluated in our study.Methods: In this observational study, 60 patients of tubotympanic COM between 12-60 years of age with small to medium sized central perforation and air-bone gap of less than 45 decibel were included. They were divided into two groups (group A and group B) of 30 patients each. Group A underwent microscopic type 1 tympanoplasty and group B underwent endoscopic type 1 tympanoplasty. The duration of the surgery, the post-operative improvement in hearing and the graft uptake was analysed after 3 months of surgery. The post-operative hospital stay duration was noted. Results: The post-operative hearing improvement and the graft uptake after 3 months of the surgery was statistically not significant between the two groups. But the mean duration of the operation and the post-operative hospital stay was significantly lower in the endoscopic group with a p value <0.05.Conclusions: Endoscopes are better in otological procedures as it reduces the surgical duration, provides better visibility, lessens the post-operative hospital stay, reducing the economic burden of the patient.

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Maternal Tobacco and Alcohol Use in Relation to Child Malnutrition in Gauteng, South Africa: A Retrospective Analysis

Children ◽

10.3390/children8020133 ◽

2021 ◽

Vol 8 (2) ◽

pp. 133

Author(s):

Perpetua Modjadji ◽

Mpinane Pitso

Keyword(s):

South Africa ◽

Alcohol Use ◽

Tobacco Use ◽

Child Growth ◽

Growth Patterns ◽

World Health ◽

Poor Growth ◽

Growth Standards ◽

Validated Questionnaire ◽

Current Tobacco

Tobacco and alcohol use among mothers is associated with numerous adverse consequences for affected offspring, including poor growth and development. This study determined the association between maternal tobacco and alcohol use, and malnutrition, among infants aged ≤ 12 months (n = 300), in selected health facilities situated in Gauteng, South Africa. Data on alcohol and tobacco use were collected using a validated questionnaire, in addition to mothers’ socio-demographic characteristics and obstetric history. Stunting (low height/length-for-age), underweight (low weight-for-age) and thinness (low body mass index-for-age) were calculated using z-scores based on the World Health Organization child growth standards. The association of tobacco and alcohol use with stunting, underweight and thinness was analysed using logistic regression analysis. The results showed a mean age of 29 years (24.0; 35.0) for mothers and 7.6 ± 3 months for infants, and over half of the mothers were unemployed (63%). Approximately 18.7% of mothers had used tobacco and 3% had used alcohol during pregnancy. The prevalence of current tobacco and alcohol use among mothers were estimated at 14.3% and 49.7%, respectively, and almost three-quarters (67.3%) of them were still breastfeeding during the study period. Stunting (55%) was the most prevalent malnutrition indicator among infants, while underweight was 41.7%, and thinness was 22%. Current tobacco use was associated with increased odds of being thin [OR = 2.40, 95% CI: 1.09–5.45), and after adjusting for confounders, current alcohol use was associated with the likelihood of being underweight [AOR = 1.96, 95% CI: 1.06–3.63] among infants. Future prospective cohort studies that examine growth patterns among infants who are exposed to maternal tobacco and alcohol use from the intrauterine life to infancy are necessary to inform, partly, the public health programmes, to reduce malnutrition among children.

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Microbiology of cerumen in patients with recurrent otitis externa and cases with open mastoidectomy cavities

The Journal of Laryngology & Otology ◽

10.1258/002221504323011978 ◽

2004 ◽

Vol 118 (4) ◽

pp. 260-262 ◽

Cited By ~ 3

Author(s):

Yavuz Selim Pata ◽

Candan Öztürk ◽

Yücel Akbaş ◽

Murat Ünal ◽

Kemal Görür ◽

...

Keyword(s):

Staphylococcus Epidermidis ◽

Otitis Externa ◽

Chronic Otitis Media ◽

Open Cavity ◽

Microbial Flora ◽

Microbial Count ◽

Group A ◽

The Common ◽

The Mean ◽

Group B

This study investigated the common flora of human cerumen in patients with recurrent otitis externa, and subjects who had been operated on and had an open mastoidectomy cavity from chronic otitis media.Cerumen samples were collected from three groups; group A (n = 20) consisted of patients with recurrent otitis externa, group B (n = 20) consisted of patients with an open cavity and group C (n = 30) consisted of healthy subjects.The mean of the microbial count was 3.4 × 104 in group A, 3.08 × 104 in group B and 2.48 × 104 in group C. The most commonly isolated microorganism from the three groups was Staphylococcus epidermidis. No growth was observed in five cases (25 per cent) in group A and in three cases (10 per cent) in group C. In groupB antimicrobial growth was observed in all samples. In 46 (65 per cent) of the cerumen samples,the isolates were monomicrobial and 24 (35 per cent) of the cerumen samples were polymicrobial. The isolates were polymicrobial in 65 per cent of group A, 20 per cent in group B and 23.3 per cent in group C.In the process of investigating the microbial flora of cerumen in all the three groups, microbial growth was observed from all the samples from patients with an open cavity, unlike the other groups, and it was determined that the group with recurrent external otitis had the most abundant microbial flora.

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