scholarly journals Retrospective study of fungal elements by potassium hydroxide mount in chronic otitis media

Author(s):  
Santosh U. P. ◽  
Sanjay V. C.

<p class="abstract"><strong>Background:</strong> Chronic otitis media is defined as persistent disease of middle ear. Fungi can either be the primary pathogen or be superimposed on bacterial infections or can be secondary pathogen in previously perforated tympanic membrane. Keeping view of high prevalence of fungal infection of middle ear in hot, humid and dusty areas, retrospective study was done to detect the potassium hydroxide (KOH) mount positive in ear discharge of chronic otitis media and treat these patients.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective study based on Bapuji Hospital records between 1 January 2018 to 26 July 2019 attached to the teaching college JJM Medical College, Davangere. Patients of either sex between age group 18 months to 87 years who diagnosed with chronic otitis media and given ear discharge sample for bacterial culture and KOH mount which is taken by a single surgeon. Collected bacterial culture reports and KOH mount reports and calculated all positive reports of KOH mount reports and treated accordingly and all reports were analysed statistically.  </p><p class="abstract"><strong>Results:</strong> We found that 15.8% KOH rate positive with 9.8-21.8% probable range for KOH positivity 95% CI which will impact in modification of treatment in chronic otitis media and were effectively treated with antibiotic and antifungal ear drops and 8 patients were required oral antibiotics as well.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that in patients with COM, send ear discharge for both culture and sensitivity and KOH mount and it should be routine and always consider combined therapy i.e., antibiotic and antifungal drugs.</p>

2015 ◽  
Vol 23 (3) ◽  
pp. 116-119
Author(s):  
Somesh Mozumder ◽  
Arunabha Sengupta ◽  
Alok Ranjan Mondal ◽  
Soumik Basu

Introduction: Chronic otitis media is a long standing infection of part or whole of middle ear cleft. Its active squamosal variant (cholesteatoma) is most dangerous due to its bone eroding property. Aims & Objective: Background knowledge of ossicular status in cholesteatoma  will help us in determining the type  of reconstruction needed during the surgery. Material & methods: 60 cases of cholesteama, irrespective of age and sex [diagnosed on the basis of clinical examination , audiological and radiological evaluation] were selected during the study period of two years and their ossicular status were recorded intra-operatively. Results &  analysis: Ossicles and their parts getting involved in cholesteatoma cases , in decreasing order are : Lenticular process (in total 50 cases)>Long process of incus (in total 49 cases) > stapes super-structure(in total 29 cases) > body of incus(in total 26 cases)> head of malleus(in total 23 cases)> handle of malleus(in total 10 cases). Ossicular chain  defeact in decreasing order are : M-I-S- > M+I-S- > M-I-S+ > M+I-S+. Conclusion: In our study it was found that incus is the most vulnerable ossicle to get involved in cases of active squamosal variety of chronic otitis media where as malleus appeared to be the least susceptible one.


1976 ◽  
Vol 85 (2_suppl) ◽  
pp. 245-249 ◽  
Author(s):  
Yea Sang Liu ◽  
David J. Lim ◽  
Raymond Lang ◽  
Herbert G. Birck

A total of 175 effusions obtained from 172 patients suffering from chronic otitis media with effusions was examined for bacterial smear and culture. Eighty percent showed positive bacterial smear, but only 49% yielded positive bacterial culture. The mucoid effusions had positive cultures in only 37%, whereas the bacterial culture rate was higher in serous (59%) and leukocytic (64%) types. The isolation of common pathogens accounted for about 50% of the isolates, and nonpathogens accounted for the remaining 50%. The high incidence of microorganisms in the middle ear effusions in the present series raises the possibility of bacterial contribution in many cases of OME.


Author(s):  
Risvana P. P. ◽  
Mubeena K.

<p class="abstract"><strong>Background:</strong> Chronic otitis media is a highly prevalent disease of middle ear. As tympanoplasty plays an important role in management of otitis media it is important to predict the outcome of surgery and give proper counselling to the patient. The objective of this study was to evaluate the effectiveness of Middle ear risk index (MERI) in determining postoperative graft uptake and postoperative air bone gap closure following tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective study conducted to find the correlation between MERI and the result of tympanoplasty outcome and post-operative hearing gain. Ninety-six subjects who underwent tympanoplasty for chronic otitis media were included in the study. MERI score was calculated and was compared with postoperative graft uptake and audiogram.  </p><p class="abstract"><strong>Results:</strong> In this study there was no statistical difference in graft uptake between the MERI categories. There was statistically significant decrease in postoperative air bone gap closure in both mild and moderate categories. Other prognostic factors associated with a favourable outcome were healthy middle ear mucosa and absence of smoking.</p><p class="abstract"><strong>Conclusions:</strong> MERI did not have a direct impact on the outcome of surgery in terms of graft uptake and hearing results. However certain factors like Belluci’s criteria and smoking had an impact on the outcome. Hence MERI can be used for pre-operative counselling of the patients.</p>


2017 ◽  
Vol 131 (9) ◽  
pp. 801-804
Author(s):  
G J Kim ◽  
S Yoo ◽  
S Han ◽  
J Bu ◽  
Y Hong ◽  
...  

AbstractObjective:Cultures obtained from pre-operative middle-ear swabs from patients with chronic otitis media have traditionally been used to guide antibiotic selection. This study investigated changes in the bacterial strains of the middle ear during chronic otitis media surgery.Methods:Pre-operative bacterial cultures of otorrhoea, and peri-operative cultures of the granulation tissue in either the middle ear or mastoid cavity, were obtained. Post-operative cultures were selectively obtained when otorrhoea developed after surgery.Results:Bacterial growth was observed in 45.5 per cent of pre-operative cultures, 13.5 per cent of peri-operative cultures and 4.5 per cent of post-operative cultures. Methicillin-resistant Staphylococcus aureus was identified as the most common bacteria in all pre-operative (32.4 per cent), peri-operative (52.4 per cent) and post-operative (71.4 per cent) tests, and the percentage of Methicillin-resistant S aureus increased from the pre- to the post-operative period.Conclusion:The bacterial culture results for post-operative otorrhoea showed low agreement with those for pre-operative or peri-operative culture, and strain re-identification was required.


Author(s):  
Elif Gündoğdu ◽  
Uğur Toprak

Background: The middle ear cavity is ventilated through the aditus ad antrum. Aditus blockage contributes to the pathology of otitis media. Objective: To determine the normal values of the aditus ad antrum diameter on computed tomography and to investigate its relationship with chronic otitis media and related pathologies (tympanosclerosis and myringosclerosis). Methods: The temporal CT images of 162 individuals were evaluated retrospectively. In the axial sections, the inner diameter of the aditus was measured at the narrowest point at the cortex. The differences in diameter were compared between diseased and healthy ears. Results: In healthy individuals, the diameter was narrower in women. There was no difference between the right and left ears in healthy subjects. No correlation was found between age and diameter. In male patients with myringosclerosis, the diameter was slightly narrower on both sides but more marked on the left. In female patients with myringosclerosis, the diameter in both ears was slightly narrower. In cases of otitis media and tympanosclerosis, the diameter was less than that of healthy individuals, despite the lack of statistically significant result in all cases. Conclusion: The aditus ad antrum was narrower in diseased ears, indicating that a blocked aditus may contribute to the development of otitis media, as well as mucosal diseases.


1992 ◽  
Vol 85 (1) ◽  
pp. 131-135
Author(s):  
Nozomu Mori ◽  
Akio Shugyo ◽  
Hiroshi Furuta ◽  
Yasuki Watanabe ◽  
Takafumi Kawahara ◽  
...  

1995 ◽  
Vol 76 (1) ◽  
pp. 23-25
Author(s):  
R. M. Nursaitova ◽  
O. A. Guryanov

It is advisable to perform cautious radical operations at the same time with plasty elements. The early surgicai sanation of the middle ear is recommended allowing to preserve its elements, to increase the possibilities of reconstruction and consequently, to decrease a potential danger for acoustic function of a patient as well as for his life as a whole.


2016 ◽  
Vol 130 (S3) ◽  
pp. S221-S221
Author(s):  
Ayiheng Qukuerhan ◽  
Nilipaer Alimu ◽  
Halimulati Muertiza ◽  
Pilidong Kuyaxi

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 43-45 ◽  
Author(s):  
Steven K. Juhn ◽  
William J. Garvis ◽  
Chap T. Le ◽  
Chris J. Lees ◽  
C. S. Kim

Otitis media has a complex multifactorial pathogenesis, and the middle ear inflammatory response is typified by the accumulation of cellular and chemical mediators in middle ear effusion. However, specific biochemical and immunochemical factors that may be responsible for the severity or chronicity of otitis media have not been identified. Identification of factors involved in chronicity appears to be an essential step in the treatment and ultimate prevention of chronic otitis media. We analyzed 70 effusion samples from patients 1 to 10 years of age who had chronic otitis media with effusion for two cytokines (interleukrn-1β and tumor necrosis factor α) and total collagenase. The highest concentrations of all three inflammatory mediators were found in purulent otitis media, and concentrations were higher in younger than in older patients. Mediator concentrations were similar in samples obtained from patients having their first myringotomy for otitis media with effusion and in those who had had multiple previous myringotomies. The multiresponse star, which incorporates several biochemical parameters in one graphic illustration, may best characterize the complex nature of middle ear inflammation.


Author(s):  
Susen Lailach ◽  
Theresa Langanke ◽  
Thomas Zahnert ◽  
Susan Garthus-Niegel ◽  
Marcus Neudert

Abstract Purpose The aim of this study was to determine whether preoperative depressive symptoms influence health-related quality of life (HRQOL) after middle ear surgery in patients with chronic otitis media (COM). Methods This prospective clinical case study was conducted at a tertiary referral center. All 102 patients who had undergone middle ear surgery for COM were assessed clinically and by audiometric testing (pure tone audiometry) in pre- and postoperative settings. Disease-specific HRQOL was assessed by the validated chronic otitis media outcome test 15 (COMOT-15) and the Zurich chronic middle ear inventory (ZCMEI-21). General HRQOL was measured using the short form 36 (SF-36). Depressive symptoms were assessed using the patient health questionnaire (PHQ-D). The Charlson comorbidity index (CCI) was used to classify comorbidities. The middle ear status was determined using the ossiculoplasty outcome parameter staging (OOPS) index. Results After middle ear surgery, the total COMOT-15 and ZCMEI-21 scores improved significantly (p < 0.001). General HRQOL (total SF-36 score) was unaffected by surgery (p < 0.05). Patients without elevated depressive symptoms had significantly better total scores for the COMOT-15 (p < 0.01), ZCMEI-21 (p < 0.001), and for SF-36 (p < 0.001) postoperatively. The results of the multiple regression analyses show that, after adjusting for the OOPS, CCI, and hearing improvement, preoperative depressiveness was significantly associated with worse postoperative COMOT-15 and ZCMEI-21 outcome scores (β = 0.425 and β = 0.362, p < 0.001). Conclusion Preoperative depressiveness was an essential predictive factor for HRQOL in patients with COM. This should be considered during patient selection to provide more suitable preoperative counseling.


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