An evaluation of role of sinusitis as focal sepsis in chronic otitis media active mucosal disease: A cross-sectional survey.
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Date
2015-07
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Abstract
Background: Sinusitis causes inflammation of the middle ear mucosa with increased and persistent
mucoid/ mucopurulent discharge and remains as a active mucosal disease. Without correcting the
sinusitis the management of ear including surgery has frequently led to failures and poor prognosis Objectives: To establish the role of Sinusitis as Focal sepsis in Chronic Otitis media active mucosal
disease. An additional objective was to accentuate the need of proper diagnostic endoscopic
evaluation and improvement in middle ear mucosal disease status after functional endoscopic sinus surgery. Material and methods: A total of 50 patients aged 18-49 years with Chronic otitis media active
mucosal disease (Tubotympanic type of C.S.O.M.) patients with persistent ear discharge even
following culture directed topical and systemic antibiotics with 3 months and more of ear discharge
seeking care at Otorhinolaryngology outpatient department were included in this study. Results: Mean age of patients was 42.5 ± 10.6 years. 76% subjects were found having septal
deviation/ turbinoseptal deformity which was the most common anatomical variant, 34% had enlarged
middle turbinate, 32% had medialised uncinate, 30% had enlarged bulla, 22% had enlarged bulla with
prominent agger and 18% had paradoxical middle turbinate. Of these 22 patients had the accessory
ostium in the posterior fontanel and 10 patients had accessory ostium in the anterior fontanel. Majority (26, 52%) of subjects had Grade I disease i.e. minimal disease limited to Osteo Meatal
Complex followed by Grade II 24% i.e. moderate incomplete opacification of one or more sinuses.
On otoendoscopy, 36 patients (72%) had a large central perforation, while 14 patients (28%) had a
subtotal central perforation Conclusion: A thorough diagnostic nasal evaluation of all Chronic Otitis Media active mucosal type
of patients is essential in comprehensive management of the disease. Deviated nasal septum, enlarged
middle turbinate, medialised uncinate predispose to sinusitis.
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Keywords
Chronic otitis media active mucosal disease, Sinusitis, Functional endoscopic sinus surgery
Citation
Ahmad Z, Singh A, Goel S, Gupta A, Panesar S, Surana A, Rajesh D R, Chitti Babu G, Bharat M, Singh LK. An evaluation of role of sinusitis as focal sepsis in chronic otitis media active mucosal disease: A cross-sectional survey. International Archives of Integrated Medicine. 2015 Jul; 2(7): 11-15.