Anterior epitympanic attic antrum space obstruction and symptom onset associated with myringosclerosis in benign chronic suppurative otitis media

Background: The AAA (Anterior epitympanic, Attic, and Antrum) space is the space between the mastoid and middle ear which functions to balance the pressure in both organs (buffer). Pathological tissue in the AAA cavity due to chronic infection would disrupt the buffer function and could change the morphology of the mucosa in the tympanic membrane and middle ear. Obstruction in the AAA space measured subjectively by observing the smoothness of the flow using saline solution has been shown to be associated with a plaque in the tympanic membrane (myringosclerosis) in Chronic Otitis Media (COM) patients. This study aims to determine the relationship between AAA space obstructions with myringosclerosis using CT-Scan for an objective result.Methods: Retrospective study with case-control approach used in this study. Case criterias are Chronic Suppurative Otitis Media (CSOM) patients with myringosclerosis, both men and women and age 15-50 years, while the control group are benign CSOM patients without myringosclerosis. Data were analyzed with the chi-square test to prove the association between the AAA space status and length of symptom onset with myringosclerosis.Results: During January 2017-December 2019 there were 33 respondents, 19 cases and 14 controls, 21 men and 12 women with an average age of 35 years (cases) and 23.5 years (control). The length of symptom onset more than 5 years (p <0.05, OR 6.94 with CI 0.5-1.5) and AAA space obstruction (p <0.05 OR 34.25 with CI 0.8-1.8) has been shown to be associated with myringosclerosis in people with benign CSOM.Conclusions: AAA space obstruction and symptom onset more than 5 years significantly associated with myringosclerosis.

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Development of an ear cap in chronic suppurative otitis media using additive manufacturing and TRIZ

Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine ◽

10.1177/0954411918780126 ◽

2018 ◽

Vol 232 (7) ◽

pp. 733-738 ◽

Cited By ~ 1

Author(s):

Mahesh B Mawale ◽

Abhaykumar Kuthe ◽

Anupama M Mawale ◽

Sandeep W Dahake

Keyword(s):

Hearing Loss ◽

Additive Manufacturing ◽

Otitis Media ◽

Middle Ear ◽

Prevalence Rate ◽

Chronic Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media ◽

Collaborative Tool ◽

Middle Ear Infection

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.

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Investigation of the Presence of Biofilms in Chronic Suppurative Otitis Media, Nonsuppurative Otitis Media, and Chronic Otitis Media with Cholesteatoma by Scanning Electron Microscopy

The Scientific World JOURNAL ◽

10.1155/2013/638715 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 17

Author(s):

Ercan Kaya ◽

Ilknur Dag ◽

Armagan Incesulu ◽

Melek Kezban Gurbuz ◽

Mustafa Acar ◽

...

Keyword(s):

Electron Microscopy ◽

Scanning Electron Microscopy ◽

Otitis Media ◽

Middle Ear ◽

Chronic Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Middle Ear Mucosa ◽

Suppurative Otitis Media ◽

Tissue Samples ◽

Scanning Electron

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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Tympanosclerosis: review of literature and incidence among patients with middle-ear infection

The Journal of Laryngology & Otology ◽

10.1017/s0022215100157937 ◽

1999 ◽

Vol 113 (12) ◽

pp. 1076-1080 ◽

Cited By ~ 46

Author(s):

Saad Asiri ◽

Alaa Hasham ◽

Fatma Al Anazy ◽

Siraj Zakzouk ◽

Adel Banjar

Keyword(s):

Hearing Loss ◽

Tympanic Membrane ◽

Otitis Media ◽

Middle Ear ◽

Clinical Picture ◽

Pure Tone ◽

Chronic Suppurative Otitis Media ◽

Review Of Literature ◽

Suppurative Otitis Media ◽

Middle Ear Infection

AbstractThe aim of the study was to review the literature of tympanoscierosis especially its pathogenesis, to study the general incidence of tympanoscierosis among patients with chronic suppurative otitis media (CSOM), its association with cholesteatoma and also the type of hearing loss as well as its relation to the degree and site of tympanosclerosis.Seven hundred and seventy-five patients with CSOM were studied retrospectively. A full history was taken and thorough ENT examinations were carried out. Pure tone audiograms (PTA) of all patients were done and analysed. The operative finding of tympanosclerosis as well as middle-ear status were inspected.The incidence of tympanosclerosis was found to be 11.6 per cent (90 patients out of 775 CSOM cases). Most tympanosclerosis cases had dry ear, (85.6 per cent). Of the 57.8 per cent who had myringosclerosis, their PTA showed an AB gap 20–40 dB. When sclerosis affect both the tympanic membrane and middle ear, 61 per cent of patients had an AB gap >40 dB. The association of cholesteatoma and tympanosclerosis may be regarded as uncommon, 2.2 per cent.The exact aetiology and pathogenesis of tympanosclerosis is as yet not well known. Our study concentrated on the clinical picture of tympanosclerosis among patients with CSOM. The majority of hearing loss associated with tympanosclerosis was of the conductive type.

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Eustachian tube mucociuary transport in chronic suppurative otitis media

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0406148j ◽

2004 ◽

Vol 132 (5-6) ◽

pp. 148-151 ◽

Cited By ~ 2

Author(s):

Snezana Jesic ◽

Vladimir Nesic

Keyword(s):

Tympanic Membrane ◽

Otitis Media ◽

Eustachian Tube ◽

Middle Ear ◽

Chronic Suppurative Otitis Media ◽

Traumatic Rupture ◽

Mucociliary Transport ◽

Tympanic Cavity ◽

Suppurative Otitis Media ◽

Mean Time

Eustachian tube dysfunction is one of the well-known factors leading to development of chronic suppurative otitis media. Tube mucociliary transport is important for elimination of the inflammation products from the middle ear enabling recovery of the affected mucosa of the middle ear, local circulation and restoration of normal air pressure in the middle ear. The study was aimed at determining: 1. whether perforation site on the tympanic membrane influences tube mucociliary transport time in individuals with traumatic rupture of the eardrum; 2. possible time difference of tube mucociliary transport between group of patients with chronic suppurative otitis media and group of patients with traumatic rupture of the tympanic membrane; 3. possible time difference of tube mucociliary transport between chronic tubotympanic type of suppurative otitis media, so called tubotympanic otitis media and atticoantral type of chronic suppurative otitis media, the so called atticoantral otitis; 4. the association between the degree of defect of the tympanic membrane mucosa and time of tube mucociliary transport in each individual type of chronic suppurative inflammation of the middle ear. Eustachian tube mucociliary transport was studied in 16 patients with tubotympanic otitis, in 13 patients with atticoantral otitis and in 9 patients with traumatic rupture of the eardrum (control group of patients). All patients were treated at the Institute of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia in Belgrade during 2002. Tube mucociliary transport was studied upon instillation of 10 ?l 5% sterile saccharine solution through the existing eardrum perforation in the course of preoperative preparation of the patient for surgical intervention. The time interval from the moment of sterile saccharine solution application till perception of the sweet taste in the mouth and pharynx was measured in studied patients. The obtained results were analyzed using the methods of descriptive and analytical statistics (t-test for small independent samples). The mean time of tube mucociliary transport in patients with traumatic rupture of the tympanic membrane was 7.6 minutes. The mean time of tube mucociliary transport in tubotympanic otitis with normal mucosa of the tympanic cavity promontorium was 15 minutes, while mean time of tube mucociliary transport in tubotympanic otitis with polypoid changes of the promontory mucosa was 24 minutes (t=5.218; p<0.01). Mean time of tube mucociliary transport in atticoantral otitis with normal promontory mucosa of the tympanic cavity was 35.5 minutes, while mean time of mucociliary tube transport in atticoantral otitis with polypoid changes of promontory mucosa was 48 minutes (t=6.99; p<0.01). In the irreversibly changed tympanic cavity mucosa, tube clearance saccharine test was negative even after one hour. The results of our study indicate the possibility that prolonged mucociliary tube transport has greater influence to development of atticoantral otitis rather than to development of tubotympanic otitis. The association between the degree of mucosal defect and time of mucociliary transport was evidenced in both types of chronic suppurative inflammation of the middle ear.

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A comparative study of tragal cartilage and autologous incus for ossicular chain reconstruction in type IIB tympanoplasty at Dr. Hedgewar Hospital, Aurangabad

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20195693 ◽

2019 ◽

Vol 6 (1) ◽

pp. 78

Author(s):

Bharat G. Deshmukh ◽

Deepak Bhisegaonkar ◽

Akanksha Bakre

Keyword(s):

Tympanic Membrane ◽

Otitis Media ◽

Middle Ear ◽

Chronic Otitis Media ◽

Ossicular Chain ◽

Suppurative Otitis Media ◽

High Incidence ◽

Ossicular Chain Reconstruction ◽

Small Bones ◽

Set Up

Background: Tympanoplasty is the surgical operation performed for the reconstruction of the eardrum (tympanic membrane) and/or the small bones of the middle ear. Chronic otitis media is a very common condition of middle ear which not only has a high incidence in the world but also in our set up. So, in view of this, we decided to conduct a study on the surgical management of CSOM-tubotympanic type.Methods: We conducted this study at ENT department of Dr. Hedgewar Rugnalaya, Aurangabad to compare air bone gap closure by using tragal cartilage and autologous incus in type IIB tympanoplasty in patients with chronic suppurative otitis media, (tubotympanic). 66 patients with central perforation of tympanic membrane, necrosed incus and mobile stapes requiring type IIB tympanoplasty, were included as a part of the study.Results: We performed type IIB tympanoplasty with a routine post-aural incision in 66 patients. According to our observation, both incus and cartilage are good materials for ossiculoplasty, tragal cartilage being better.Conclusions: After conducting this study we concluded that incus and tragal cartilage both are excellent materials for ossiculoplasty.

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Biofilm presence in humans with chronic suppurative otitis media

Otolaryngology ◽

10.1016/j.otohns.2009.08.010 ◽

2009 ◽

Vol 141 (5) ◽

pp. 567-571 ◽

Cited By ~ 37

Author(s):

Michael Robert Lee ◽

Karen Sue Pawlowski ◽

Amber Luong ◽

Alexis Dorian Furze ◽

Peter Sargent Roland

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Group Versus ◽

Laser Scanning Microscopy ◽

Chronic Suppurative Otitis Media ◽

Control Group ◽

Middle Ear Surgery ◽

Suppurative Otitis Media ◽

Female Ratio ◽

Significant Difference

Objective: To study the presence of biofilm formation in humans with chronic suppurative otitis media (CSOM). Study Design: Cross-sectional study. Setting: Tertiary academic hospital. Subjects and Methods: Patients undergoing middle ear surgery between July 2006 and March 2008. Tissue samples were obtained from 25 patients, of which 20 specimens were successfully processed for this study. The remaining samples were not analyzed due to sample damage or loss during preparation. Of the 20 specimens studied, 10 were harvested as the experimental group from patients with CSOM and the other 10 harvested as controls from patients undergoing otologic surgery for acoustic neuroma, cochlear implant, or routine tympanoplasty. Ages ranged from 26 to 74 years (mean 45 yrs). Male-to-female ratio was 2:3. Scanning electron microscopy and confocal laser scanning microscopy were used to identify the presence of biofilms. Live-dead staining was used to assess whether bacteria present were viable. The outcome measured was the presence of adherent biofilms on middle ear mucosa. Results: Biofilms were present in six of 10 samples (60%) from the CSOM group, but only in one of 10 control samples (10%). Comparative analysis revealed a statistically significant difference ( P < 0.05) in the presence of biofilms in specimens from the CSOM group versus the control group. Conclusion: Biofilms were statistically more common in patients with CSOM compared with control patients.

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Colligation of Hearing Loss and Chronic Otitis Media

10.53350/pjmhs211581817 ◽

2021 ◽

Vol 15 (8) ◽

pp. 1817-1819

Author(s):

Bakht Aziz ◽

Nasir Riaz ◽

Ateeq ur rehman ◽

Mohammad Irshad Malik ◽

Kashif Iqbal Malik

Keyword(s):

Hearing Loss ◽

Otitis Media ◽

Middle Ear ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Sampling Technique ◽

Chronic Suppurative Otitis Media ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Suppurative Otitis Media

Background: Permanent perforation in the eardrum with persistent drainage from middle ear for more than six weeks is labelled as chronic suppurative otitis media. The major disability of long standing chronic suppurative otitis media presents as disability in hearing thresholds both in young children and adults. The disease has a fewer prevalence in urban regions and mostly is found in the rural population. Aim: To identifying the Prevalence of hearing loss which is sensorineural in patients having middle ear chronic infection (CSOM). Study design & setting: Cross-sectional survey conducted in the department of ENT, Jinnah Hospital Duration/date of the study: 01st February 2020 to 31STJuly 2020 Methods: A Total number of 180 patients were included as a sample in the study. Keeping the level of confidence to 95% and keeping the margin of error to minimum to 5%. These statistics were generated keeping the frequency level of hearing in these patients to minial of 16%. The sampling technique would be non probability type of sampling with a purpose. Results: The results of the study concluded that patients of both sex ranged between first decade and fifth decade. A total of 180 patients had 114 male gender and 66 female gender patients. Patients having chronic middle ear disease were segregated into CSOM (tubo tympanic) with 137 patients and CSOM (attico antral) with 43 patients. The primary indicator of hearing loss in these patients however showed 23 patients having a hearing loss of sensori neural type and 157 patients did not have any sensori neural hearing loss. Conclusions: This research study draws a conclusion that majority cases of chronic middle ear infection is usually the safe type (Tubo tympanic) while a very fewer of these patients of CSOM would have (Attico antral) or dangerous type of CSOM. The major variable of the research, in the form of hearing loss which was sensori neural in patients presenting with CSOM was (12.8%). This percentage is much lower when compared with conductive hearing loss in CSOM. Keywords: Otitis media of chronic type with suppuration, pure tone audiometry, sensory neural hearing loss

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EVALUATION OF MASTOID PATHOLOGY IN TUBOTYMPANIC TYPE OF CHRONIC SUPPURATIVE OTITIS MEDIA

UP STATE JOURNAL OF OTOLARYNGOLOGY AND HEAD AND NECK SURGERY ◽

10.36611/upjohns/2020/issue1/5 ◽

2020 ◽

Vol VOLUME 8 (ISSUE 1) ◽

pp. 30-34

Author(s):

Sumit Sharma

Keyword(s):

Otitis Media ◽

Eustachian Tube ◽

Middle Ear ◽

Age Groups ◽

Chronic Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Nasal Allergy ◽

Suppurative Otitis Media ◽

Number Of Factors ◽

Tube Dysfunction

Otitis media is an in􀃸ammation of a part or whole of the mucoperiosteal lining of the middle ear cleft which is composed of Eustachian tube, h y p o t y m p a n u m , m e s o t y m p a n u m , epitympanum, aditus and mastoid air cells(1). It is one of the commonest ear disease of all age groups and it is caused by multiple interrelated factors including infections, eustachian tube dysfunction, nasal allergy and trauma. The disease has been classi􀃶ed on the basis of its underlying pathology as active or inactive mucosal, active or inactive squamosal and healed chronic otitis media (2). A number of factors are involved in the outcome of surgery for Chronic suppurative Otitis media and one of them is condition of the mastoid. According to Jackler and Schindler (3) Mastoid factors are extent of pneumatization and presence of in􀃸ammatory disease in mastoid. Holmquist and Bergstorm (4) in 1978 said that well aerated mastoid is a prerequisite for well ventilated middle ear and long lasting success. KEY WORDS: SAFE OTITIS MEDIA, MASTOIDECTOMY, MASTOID ANTRUM.

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EFFICACY OF ACETIC ACID VERSUS CIPROFLOXACIN EAR DROPS IN ACHIEVING DRY EARS IN CHRONIC SUPPURATIVE OTITIS MEDIA IN ADULT POPULATION OF ISLAMABAD, PAKISTAN: A NON-RANDOMIZED CONTROL TRIAL

Gomal Journal of Medical Sciences ◽

10.46903/gjms/17.03.2007 ◽

2020 ◽

Vol 17 (3) ◽

pp. 90-94

Author(s):

Arslan Akhtar ◽

Syed Maisam Ali ◽

Syed Ali Naqi ◽

Tabassum Aziz ◽

Wajih-ud-din Shinwari ◽

...

Keyword(s):

Acetic Acid ◽

Otitis Media ◽

Adult Population ◽

Chronic Suppurative Otitis Media ◽

Control Group ◽

Chi Square ◽

Suppurative Otitis Media ◽

Acid Versus ◽

Experimental Group ◽

Ear Drops

Background: Chronic suppurative otitis media (CSMO) is an important cause of preventable hearing loss, particularly in developing world. The objective of this trial was to compare efficacy of 2% acetic acid versus 0.3% ciprofloxacin ear drops in achieving dry ears in CSMO in adult population of Islamabad, Pakistan. Materials & Methods: This trial was conducted at Department of ENT, HBS Medical College, Islamabad, Pakistan from March 2018 to February 2019. With alpha 5%, beta 20% and power of study 80%, sample size was calculated 47 for each group. All adult patients of CSOM, having ear discharge for more than three months were eligible. Patients with aural poly, external auditory canal pathology, ear malignancy, having mastoid surgery in preceding 12 months or having used antibiotics in last one week were excluded. Experimental group received 2% acetic acid, twice daily while control group received 0.3% ciprofloxacin eardrops twice daily. At two weeks, achievement of dry ears was noted. Sex and age in years were matching variables. Primary end point was achieving dry ears, which was compared between the two groups using McNemar chi-square test. Results: Experimental group included 30 (63.8%) men and 17 (36.2%) women and control group included 32 (68%) men and 15 (32%) women. Mean age of experimental group 36±2.14 years was matching to the control group 36±2.59 years. Dry ears were achieved in 35 (74.47%) patients in experimental group and in 11 (23.40%) patients in control group. The efficacy of 2% acetic acid was significantly higher than 0.3% ciprofloxacin eardrops in achieving dry ears (p

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Bacteriological study and antibiotic sensitivity profile in patients with ear discharge visiting ENT OPD at tertiary care center

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20175632 ◽

2017 ◽

Vol 4 (1) ◽

pp. 237

Author(s):

Kailas R. Patel ◽

Alpesh D. Fefar ◽

Paresh J. Khavdu ◽

Sejal N. Mistry ◽

Manish R. Mehta

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Otitis Media ◽

Middle Ear ◽

Chronic Otitis Media ◽

Antibiotic Sensitivity ◽

Polymyxin B ◽

Chronic Suppurative Otitis Media ◽

Purulent Discharge ◽

Suppurative Otitis Media

Background: Otitis media (OM) is a big menace in countries like India. Chronic suppurative otitis media (CSOM) is chronic inflammation of middle ear, which affects the tympanic membrane, middle ear mucosa and other middle ear structures characterised by the presence of persistent perforation or persistent mucoid or muco-purulent discharge for at least 8 weeks. Variety of organisms founds in patients suffering from chronic otitis media like, Pseudomonas, Staphylococcus aureus, Proteus mirabilis, Klebsiella pneumonia and Escherichia coli found. The pattern of organisms varies in different geographical areas. The objectives of the study were to isolate bacteria from patients with ear discharge, to find out antibiotic sensitivity of isolated organismsMethods: This is an observational cross sectional study done in the OPD department of otorhinolaryngology, at P.D.U medical college and hospital, Rajkot, for a period of six months from January 2017 to June 2017. A total number 200 patients of both gender between 5 to 74 years who visited the OPD department of otorhinolaryngology with chronic ear discharge taken for study. Results: Out of 200 patients of 5-74 years with chronic suppurative otitis media were examined and out of this Hundred and twelve (54%) of the patients were males with mean age of 33.44. Pseudomonas aeruginosa was the commonest identified organisms the sensitivity pattern highly favoured Pipercillin, Amikacin and Polymyxin B, Cefoparazone. Conclusions: Chronic otitis media is more prevalent in males than females. Commonest organisms found were Pseudomonas aeruginosa followed by Staphylococcus aureus. Piperacillin, Amikacin, Gentamicin, Polymyxin B and Cefoperazone were found most effective agents against Pseudomonas aeruginosa.

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