Keywords : otitis media
CLINICO-MICROBIOLOGY OF CHOLESTEATOMA OBTAINED DURING MASTOID SURGERY IN PATIENTS WITH CHRONIC SUPPURATIVE OTITIS MEDIA
Basrah Journal of Surgery,
2021, Volume 27, Issue 1, Pages 36-40
Abstract Chronic Otitis Media (COM) is a long standing inflammation of the middle ear and mastoid, it is a common health problem. The evidence of microbiology in COM in different studies showed variable frequencies, but little studies showed the role of fungal colonization. This study aimed to identify the microbiology of cholesteatomatous COM concentrating on clarification of fungal colonization. A prospective study was done in otolaryngology department of Basrah Teaching Hospital from June 2018 till July 2019. This study was carried on a randomly collected data of 25 patients diagnosed as COM by a specific designed questionnaire including history and examination. The specimen was collected during mastoid surgery which included any cholesteatoma in the middle ear and mastoid and sent for bacteriological and mycological examination. Statistical study was done by using SPSS v.23 Bacteria were isolated in 84% of the cases in which Pseudomonas aeruginosa was the commonest one (33.3%). Fungi were isolated in 28% cases, in which the Aspergillosis was the commonest (19.3%). There is no recognizable pattern of significant association between the fungi and the reported complications or the stage of the disease. In conclusion, there is significant percentage of fungal colonization in COM with cholesteatoma so it may has a role in inflammatory response of perimatrix, but there is no clear mechanism of this interaction, so may need larger sample and longer duration of study with postoperative follow-up and trail of combined antibiotic-antimycotic treatment. Key words: clinical,microbiology, cholesteatoma, mastoid surgery, otitis media.
Basrah Journal of Surgery,
2019, Volume 25, Issue 2, Pages 70-75
Otitis media with effusion (OME) is a chronic accumulation of fluid within the middle ear cleft and sometimes the mastoid air cells system. The disease is more common among children. Surgical management is cost effective and carry complications from anaesthesia and surgical intervention. The condition can be resolved with high percentage by using mucopeptide breaking agent N-acetylcysteine
The aim of this study is to evaluate the effect of N-acetylcysteine on the resolution of otitis media with effusion in children.
Fifty seven children (107 ears) aged between 4-15 years with OME were included in this study. Patients underwent a thorough otorhinolaryngological examination and were divided into two groups; in the study group of 30 patients, N-acetylcysteine was administered, and the control group of 27 patients did not receive this treatment.
Patient were followed-up at attendance, one month, two months and three months later with microscopical ear examination, tympanometric and pure tone audiometric examination.
Patients were 39 males (68.4%) and 18 females(31.6%), 50 of them were with bilateral and 7 with unilateral disease. Following the treatment, there was improvement in the hearing loss as air bone gap was decreased. This improvement was statically significant in comparing the study and control groups (P value= 0.022). Number of ears with type A tympanogram increased to a rate of 74%, 71% in the right and left ears respectively in the study group. This rate was statically significant in comparing with the control group (P value=0.014).
In conclusion, N-acetylcysteine is effective in the treatment of children with OME as well as that N-acetylcysteine has minimal side effect and can be used safely in patients who are medically unfit for general anaesthesia