Metrics details Abstract To determine the incidence of otogenic complications of Chronic suppurative otitis media CSOM and its management. The study was conducted at the tertiary referral centre and teaching hospital. An analysis was made about the clinical and operative findings, surgical techniques and approaches, the overall management and recovery of the patient. The data were then compared with the relevant and available literature. Out of these 45 cases, 20 cases had extracranial EC while 25 cases had intracranial IC complications.
|Published (Last):||22 July 2010|
|PDF File Size:||18.13 Mb|
|ePub File Size:||2.59 Mb|
|Price:||Free* [*Free Regsitration Required]|
Cholesteatoma Bhutta MF et al. It is caused by an ongoing inflammatory response within the middle ear with granulation , and is typically associated with unresolved and resistant bacterial infections. Around 0. In this article, we shall look at the risk factors, clinical features and management of chronic otitis media. Terminology There are many terminologies associated with chronic otitis media, which relate to different aetiologies: Mucosal COM - chronic inflammation secondary to a perforation Fig.
Other associated risk factors include traumatic perforation of the TM, insertion of grommets, and craniofacial abnormalities. If fever or pain is present then other diagnoses should be considered, such as otitis externa, mastoiditis or intracranial involvement. Patients will often have a history of recurrent AOM, previous ear surgery or trauma to the ear.
It is important to test facial nerve function and document this clearly. Hearing loss can occur, which is nearly always conductive hearing loss, unless the disease is extensive Investigations Audiograms and tympanometry should be performed, although this is not possible in a heavily discharging ear.
Swabs can be useful in cases of treatment failure. Whilst the diagnosis of COM is made clinically, any suspicion of cholesteatoma warrants a CT scan of the petrous temporal bone for further assessment. Any suspected cholesteatoma should be urgently investigated further. The patient should be counselled on the importance of keeping the ear clean and dry. Most TM perforations will heal spontaneously however large perforations may persist and referral for potential surgical management may be required.
Surgical Management Surgical treatment options are available but the success rate of surgical repair is dependent on the size and site of the perforation.
The aim of closing a perforation is to relieve symptoms of persistent discharge and prevent recurrent infection. Surgery can potentially improve hearing, although this will largely depend on the pre-operative state of the auditory apparatus. The main aim for surgery however is to obtain a dry ear. Surgical options include: Myringoplasty - closure of perforation in pars tensa The closure is achieved by patching on an autologous graft, usually harvested from the tragal cartilage or temporalis fascia.
Tympanoplasty — a myringoplasty combined with reconstruction of the ossicular chain [start-clinical] Referred Ear Pain If the external ear canal and drum are normal, with normal pneumatic speculum, pain is not from ear disease but instead referred pain. In this condition, epithelial cells naturally shed within this pocket but cannot escape the middle ear and so the collection grows Fig. This abnormal migration of squamous epithelium in turn leads to cell debris building-up and the forming of a cholesteatoma.
It has no metastatic potential but can potentially have devastating locally destructive effects if left untreated. They grow independently and can affect the bones of middle ear, facial nerve, inner ear, and skull base. Congenital cholesteatoma are rare and difficult to detect. Diagnosis is made clinically during examination whereby a pearly, keratinized, or waxy mass in the attic region is seen Fig. These are best seen when a perforation of the TM is present, providing a window into the middle ear.
Management Definitive management of a cholesteatoma will be surgery, aiming to remove the entire cholesteatoma or it will recur. Access to the mastoid is traditionally made using a post-auricular or pre-auricular incision although increasingly can be accessed endoscopically. The ossicles can be reconstructed depending on the damage caused by the cholesteatoma.
Otitis media - chronic suppurative
Cholesteatoma Bhutta MF et al. It is caused by an ongoing inflammatory response within the middle ear with granulation , and is typically associated with unresolved and resistant bacterial infections. Around 0. In this article, we shall look at the risk factors, clinical features and management of chronic otitis media. Terminology There are many terminologies associated with chronic otitis media, which relate to different aetiologies: Mucosal COM - chronic inflammation secondary to a perforation Fig. Other associated risk factors include traumatic perforation of the TM, insertion of grommets, and craniofacial abnormalities.
Complications of chronic suppurative otitis media and their management.
Shaktibar Occupation The patients included students and housewives. Durg, Chhattisgarh India. The reliable warning signs and symptoms of IC complications were fever, headache, earache vestibular symptoms, meningeal signs and impairment of consciousness. Ceftriaxone depending on culture ccomplication sensitivity.