DEMOGRAPHIC INFLUENCES ON COMPLICATED CHRONIC SUPPURATIVE OTITIS MEDIASameer RQ, Uneeba RRIndian Journal of Otology July 2015

BESTH HUTABARAT

14014101199

ABSTRACT

INTRODUCTION Chronic suppurative otitis media (CSOM) is otitis media with perforated

tympanic membrane with persistent drainage from the middle ear lasting for 6-12 weeks more.

Commonly a disease of the developing world with malnutrion, over-crowding, substandard hygiene, frequent upper respiratory tract infection and under-resourced health care (all linked to low economic status) listed as risk factors.

There are 50% of cases, hearing loss associated with the chronic discharging ear.

The cycle of inflammation, ulceration, infection and granulation formation -> destroying the sorrounding bony margins and leading to various complications of CSOM.

INTRODUCTION Common pathogens : bacteria (Pseudomonas aeruginosa, Staphylococcus

aureus, and anaerobs), and certain fungi. Complication of CSOM :

- extracranial : mastoiditis, facial nerve paralysis, labrynthitis, petrositis (presentations : facial weakness, vertigo, tinnitus, mastoid tenderness and sweeling, diplopia)

- intracranial : neck stiffness , brain abscess, lateralsinus thrombosis. Contributing factors in the progression of CSOM to complicated CSOM :

- age - organism’s virulence - immune status

- socioeconomic status - cholesteatoma

MATERIALS AND METHODS A descriptive cross-sectional study In a tertiary care hospital Jinnah Postgraduate Medical Centre Karachi

in Departement of ENT Head and Neck Surgery from 2008 – 2013 Total : 65 patients (nonprobability convenient sampling) -> 42 males

and 23 females Inclusion criteria : (1) age 10-45 years old (group A = 10-18 years, group

B = 18-45 years)

(2) CSOM with intra/extracranial complications

Exclusion criteria : (1) uncomplicated CSOM with dry perforation Analyzing data : SPSS version 19, chi-square test

RESULTS

Percentage of population gender : male 63,1%, females 36,9%

Majority : history of ear discharge and hearing loss (+) Total mean age = 18,28 years old Crosstabs : - duration of complain and family income p=

0,05

- age of patient and diagnosis p= 0,00

DISCUSSIONChronic suppurative otitis media is an infection commonly associated with poor socioeconomic status or poverty‑related conditions such as malnutrition, over‑crowding, substandard hygiene, frequent upper respiratory tract infections and under‑resourced health care.

CONCLUSIONS

Most common complication of CSOM is an extracranial complication mastoiditis occurring more in group A, with male predominance.

Important factor :

- low socioeconomic background -> negligence to seek medical assistance on time and delayed treatment.

- irrational and excessive use of antibiotics by local doctors without prior bacteriology

Proper education and adequate precautions -> reduced cases significantly -> decreasing the unnecessary financial burden on the state and loss of human resources

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