Arun Kumar, G (2022) A Comparative study on Management of Chronic Suppurative Otitis Media with Sinusitis With and Without Fess. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION Chronic otitis media (COM) is considered as a major otological problem. Chronic otitis media is defined as ―persistent inflammation of the mucoperiosteal lining of the middle ear cleft. Permanent changes like perforation, retraction, atelectasis and tympanosclerosis in tympanic membrane are common in COM. The Chronic otitis media is one of the major cause of hearing loss in developing countries. Globally, nearly 65 to 330 million people are affected with Chronic otitis media and causing around 28,000 mortality yearly. The prevalence of Chronic otitis media is around 2 to 4 % in South East Asia where as in India, 6 % suffer from the same. The major risk factors for the development of COM is malnutrition, passive exposure to smoking, low socioeconomic status etc. Chronic sinusitis acts as an infective focus which can result in the development of chronic suppurative otitis media. Literature have shown that inter relationship occurs between them. OBJECTIVES: 1. To study the effect of Functional Endoscopic Sinus Surgery in patients affected with Chronic Suppurative Otitis Media with Chronic rhinosinusitis. 2. To analyse the association of nasal and paranasal sinus pathologies with Chronic suppurative otitis media. 3. To study the surgical outcome of mucosal type of Chronic Suppurative Otitis Media after Functional Endoscopic Sinus Surgery. MATERIAL AND METHODS: Study Design: This study was a prospective study. Study Setting: This study was conducted in Upgraded Institute of Otorhinolaryngology, Chennai. Study Duration: The study will for 13 months from June 2020 to September 2021 after the approval of hospital ethical committee. Study population: Totally 40 patients were included in the study. Sampling was obtained through convenient sampling. Inclusion criteria: ● Age >10 to <60 years. ● Both gender. ● Patient who were willing to participate, able to understand and able to give informed consent. ● Patients with history of o Chronic Suppurative Otitis Media- Tubotympanic type. o Chronic Suppurative Otitis Media with chronic rhinosinusitis. o Chronic otitis media with retraction pocket in otoscopic examination. Exclusion criteria: ● Age < 10 and > 60 years. ● Pregnant females, uncooperative patients ● Patients with acute infection of nose and paranasal sinuses. ● Patients with CSOM with cholesteatoma in otoscopic examination. ● Patients with adenoid hypertrophy or other nasopharyngeal masses. ● Patients with sensory neural hearing loss. ● Patients with associated head and neck malignancies. Investigation: ● Complete history taking and clinical examination. ● Diagnostic nasal endoscopy. ● Blood investigation- CBC, blood urea and serum creatinine, random blood sugar, serum electrolytes, bleeding time and viral markers. ● CT-PNS. ● HRCT- Temporal bone. ● Pure tone Audiometry. CONCLUSION: ❖ It can be concluded that the nasal and paranasal sinus passage obstruction can result in tubo-tympanic disease. Thereby, it can lead to development of otitis media due to inflammation of mucosa, loss of mucociliary action of epithelium and eustachian tube obstruction leading to ascending infection. ❖ Functional endoscopic sinus surgery has shown some improvement on the middle ear mucosa by improving the eustachian tube function and mucociliary action of the epithelium, thus improving the graft uptake after tympanoplasty. ❖ Despite the fact that the graft failure rate is significantly lower in patients who had FESS before tympanoplasty, it cannot be concluded that FESS is the sole reason for the better outcome; additionally, the sample size is insufficient to draw such a statistical conclusion. ❖ To provide statistical evidence in favor of functional endoscopic sinus surgery on tympanoplasty, further prospective trials with high sample sizes and thorough follow-up are required.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221914007 |
| Uncontrolled Keywords: | Management, Chronic Suppurative Otitis Media, Sinusitis, With and Without Fess. |
| Subjects: | MEDICAL > Otolaryngology > MEDICAL > Otolaryngology |
| Depositing User: | Subramani R |
| Date Deposited: | 22 Apr 2022 13:34 |
| Last Modified: | 17 Dec 2023 05:02 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/19364 |
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