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Category: Volume 07 Issue 06 June 2019
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Title: Socio-demographic & clinico-pathological correlates of chronic otitis media: a tertiary care govt. Hospital based epidemiological study in eastern India

Authors: Bijan Basak, Kaustuv Das Biswas, Ankit Choudhary, Subhradev Biswas

 DOI: https://dx.doi.org/10.18535/jmscr/v7i6.24

Abstract

Background: Chronic otitis media (COM) is the commonest disorder in Otorhinolaryngology practice, characterized by chronic inflammation of the middle ear cleft and mastoid cavity which presents with recurrent ear discharge and deafness. It results in considerable morbidity and may even cause extra-cranial and intra-cranial complications. Infections of the middle ear and complications caused by COM, are still a major public health problem in the developing countries like India. It is one of the main causes for preventable hearing loss when treated appropriately. It is important to review the changing trends in natural history of the disease, associated socio-demographic parameters & clinico-pathological findings in order to understand the pathogenesis & initiate definitive treatment.   

Objective: The present article attempts to explore the socio-demographic profile of patients with COM, attending out-patient department in a tertiary care govt. hospital in eastern India & correlate the clinico-pathological features with types of disease, its severity & risk factors for development of complications.

Material & Methods: A prospective, cross-sectional, observational study was carried out including consecutive patients with clinical diagnosis of COM. Their socio-demographic profile were recorded through a pre-designed proforma incorporating epidemiologic parameters, clinical & radiological findings. Data was statistically analyzed & correlated with literature review.

Results: In the present study, mostly male patients, of lower & upper lower socio-economic class, in the age group 21-30 years were included. Overcrowding was found to be positively associated with the risk of development of COM. Cases were mostly unilateral, mucosal but with a good number of squamous COM. Bad ear hygiene practices were highly prevalent among study population with poor knowledge about the disease. Aural discharge was the commonest presenting symptom followed by deafness. Most of the patients were suffering from the disease for long periods. Mucosal COM mostly caused mild hearing loss, whereas squamous COM caused more severe to profound hearing loss. Most of the central perforations caused mild hearing loss, subtotal & postero-superior marginal perforation caused moderate hearing loss and squamous COM with attic perforation is mostly associated with severe hearing loss. Correlation between congested/ persistently discharging and granulations/polypoidal middle ear mucosa with cholesteatoma was found to be statistically significant. Incus long process was commonly eroded & in the cases without cholesteatoma, granulation tissue in the mastoid antrum was associated with almost all the cases of ossicular necrosis. Duration of disease have been found to possess statistically significant correlation with development of complications,

Conclusion: The present study indicates that prevalence of COM can be reduced by avoiding unhealthy habits, improving health status & knowledge about the disease,. Thorough clinical examination & early & definitive management of COM helps to give the patients better outcome & reduces the chances of complications.

Keywords: chronic otitis media(COM), mucosal COM, squamous COM, cholesteatoma,  hearing loss, complications.

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Corresponding Author

Kaustuv Das Biswas