RATE OF CHRONIC SUPPURATIVE OTITIS MEDIA IN AN OTOLARYNGOLOGY CLINIC OF A TURKISH MILITARY HOSPITAL
Objective
Chronic suppurative otitis media (CSOM) is chronic inflammation of the middle ear and mastoid process and it is one of the common diseases of the ear causing mild to moderate hearing impairment.1 Its incidence appears to depend to some extent on race and socio-economic factors. Poor living conditions, overcrowding, poor hygiene and nutrition have been suggested as a basis for the widespread prevalence of CSOM in developing countries.2 If CSOM patients need surgical treatment, it may cause some changes in their hearing levels and life styles.3 Because of that we aimed to find out the rate and course of CSOM in our patients that is representative for the Turkish population.
Material and methods
The present retrospective study is designed to assess the ratio of CSOM applicants and their profile of surgical treatment course in an otolaryngology clinic of a tertiary military hospital in Turkey during a period of two years. All the patients who applied to our clinic for an otolaryngological complaint from January 2010 to January 2012 were reviewed and CSOM patients were identified according to the diagnosis. Then, if surgery was performed, the surgery types were classified.
Results
In two years, a total of 64,792 patients admitted to our clinic for all kinds of otolaryngological diseases and their symptoms. Eight hundred forty-one (1.30%) of them were found to be CSOM patients and 58 (6,90%) of those 841 patients were operated. Operated patients were mostly male (n = 55, 94.83%) and their mean age was 21.8. Of the operated ears, 53.45% (n = 31) were right ears and the others were left ears (n = 27, 46.55%). Canal-wall-down mastoidectomy was applied to 45 patients (77,59%) and canal-wall-up mastoid-ectomy was applied to the remaining patients (n = 13, 22.41%). Of the canal-wall-down mastoidectomies 60% (n = 27) and of the canal-wall-up mastoidectomies 23,08% (n = 3) were combined with tympanoplasty.
Discussion
Most of the authors say that early diagnosis of the patients with CSOM may reduce the need for a major surgery. In a long-term study it has been shown that 72% of the patients with radical mastoidectomy had similar or better hearing levels after surgery compared to hearing levels before surgery.4 We believe that an early diagnosis is important to prevent the patient from unwanted results and complications of surgery. However, surgical treatment in early stages of CSOM may be beneficial for preventing the residual hearing levels.
Conclusion
Although it seems that the rate of CSOM in our applicants is not high, it still is necessary to diagnose them during an early stage of CSOM development to reduce the need for major surgical treatments. It is also important for prevent hearing disability and other complications due to CSOM.
References
1.Reiss M, Reiss G. Suppurative cronic otitis media: etiology, diagnosis and therapy. Med Monatsschr Pharm 33(1):11–6; Quiz 17–8, 2010
2.Neogi R, et al. Clinico-epidemiological profile of chronic suppurative otitis media patients attending a tertiary care hospital. J Indian Med Assoc 109(5):324–326, 2011
3.Poliakova SD. Functional results of ‘open’ and ‘closed’ surgery on the middle ear. Vestn Otorinolaringol (5):26–27, 2010
4.Kos MI, Castrillon R, Montandon P, Anatomic and functional long-term results of canal-wall-down mastoidectomy. Ann Otol Rhinol Laryngol 113(11): 872–876, 2004
Address for correspondence: Engin Cekin, GATA Haydarpasa Egitim Hastanesi, KBB Hastaliklari Servisi, Tibbiye Cad., Uskudar/ Istanbul, Turkey. iecekin@yahoo.com
Cholesteatoma and Ear Surgery – An Update, pp. 413–414
Edited by ww Takahashi
2013 © Kugler Publications, Amsterdam, The Netherlands