Title: Clinical and Operative Study of Intracranial Complications of Chronic Suppurative Otitis Media (CSOM) and its Management
Authors: Dr V. P. Narve, Dr Priyanka Verma, Dr Vivek Verma
DOI: https://dx.doi.org/10.18535/jmscr/v7i9.135
Abstract
Introduction: Chronic suppurative otitis media (csom) is defined as chronic ear discharge more than 12 weeks through perforated tympanic membrane .the cycle of infection, inflammation, granulations tissues and cholesteatoma formation continues, destroying surrounding bony margins and ultimately leading to various complications of csom.1 Despite the availability of newer antibiotics csom can still leads to major complications in developing countries.5
Objectives: The aim and objective of this study is to study clinical presentation and intra-operative study of intracranial complications of chronic suppurative otitis media.(warning signs and symptoms, the etiological agents) and its management.
Method: This is a prospective cross sectional study carried out in department of E.N.T, Jayarogya Hospital during the period of one year from Jan 2018 to Dec 2018. All admitted cases of Intracranial complications due to CSOM of all age & gender were included. After confirmation of complication by CT/MRI, multidisciplinary approach was followed including initial treatment by systemic antibiotics up to definitive final treatment by mastoid surgery.
Results: Out of 23 patients of CSOM with Intracranial complications the age of patients ranged from 10-70 years with majority i.e. 65.21% being between 20-30years adult age group with male predominance was 69.59%. Majority of patients belong to poor socio-economic status. Otorrhea was present in all patients i.e. 100%, followed by hearing loss. Brain abscess were found in 60.8% was the most common complication followed by meningitis (30.4%). In operative findings erosion of sinus plate 34.7% followed by dura plate/ tegmen plate erosion were found 30.4%.
Conclusion: Brain abscess (60.8%) out of which (34.7%) were temporal lobe abscess were commonest intracranial complication followed by meningitis. It is important to study the pathogenesis of CSOM with complications as it is still high in young age group & low socio-economic strata, especially in rural population. With advent of new specific antibiotics & new diagnostic modalities it’s prevalence & incidence has decreased.
Keywords: CSOM, CT/MRI,CBC, AURAL SWAB C/S, CSF.
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