CC BY-NC-ND 4.0 · Annals of Otology and Neurotology 2018; 01(02): 100-104
DOI: 10.1055/s-0038-1636944
Original Article
Indian Society of Otology

Predisposing Sinonasal Disease Foci: Do They Really Affect Mucosal Chronic Otitis Media?

Vikram Kemmannu Bhat
1   Department of Otolaryngology, Head and Neck Surgery, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
,
Aroosh Thevaruparambil Paramu
2   Department of ENT, Sacred Heart General (SHG) Hospital, Alappuzha District, Kerala, India
,
Shwetha Nagachar
1   Department of Otolaryngology, Head and Neck Surgery, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
› Author Affiliations
Further Information

Publication History

Publication Date:
04 January 2019 (online)

Abstract

Background This study aimed to find the relationship between sinonasal predisposing foci in chronic otitis media mucosal disease (COMMD) and risk from these predisposing disease foci, and to identify the correlation of bacterial flora of the ear and nose in chronic otitis media.

Materials and Methods This was a prospective case–control study with 100 cases and 100 controls. All patients underwent a detailed clinical ear-nose-throat (ENT) examination and diagnostic nasal endoscopy to look for sinonasal and pharyngeal pathology. In all patients, ear and nasal swabs were taken at the first visit. The relationship between these factors and COMMD was studied by appropriate statistical tests.

Observations and Results Extremely significant association between tubal tonsil hypertrophy and COMMD, very significant association between adenoid hypertrophy and COMMD, and just significant association between deviated nasal septum, inferior turbinate hypertrophy, concha bullosa, and COMMD were found. No significant association was found between sinusitis and COMMD. In this study Staphylococcus aureus (51%) was the predominant organism isolated from ear swab, followed by Pseudomonas (27%). The same organism in nasal and ear swabs was demonstrated only in eight (13%) cases.

Conclusion Sinonasal predisposing foci play a substantial role in the development of COMMD and observed in 97% of the cases with bilateral disease and 91% with unilateral disease in this study. Hence, every case of COMMD must undergo investigations such as diagnostic nasal endoscopy to discover these foci. Because sinonasal disease is one of the important factors contributing to otitis media, timely detection and management of symptomatic sinonasal disease must precede surgical management of COMMD.

 
  • References

  • 1 Bhat KV, Naseeruddin K, Nagalotimath US, Kumar PR, Hegde JS. Cortical mastoidectomy in quiescent, tubotympanic, chronic otitis media: is it routinely necessary?. J Laryngol Otol 2009; 123 (04) 383-390
  • 2 Vikram BK, Khaja N, Udayashankar SG, Venkatesha BK, Manjunath D. Clinico-epidemiological study of complicated and uncomplicated chronic suppurative otitis media. J Laryngol Otol 2008; 122 (05) 442-446
  • 3 Kvaerner KJ, Tambs K, Harris JR, Mair IW, Magnus P. Otitis media: relationship to tonsillitis, sinusitis and atopic diseases. Int J Pediatr Otorhinolaryngol 1996; 35 (02) 127-141
  • 4 Yeolekar AM, Dasgupta KS. Otitis media: does the onus lie on sinonasal pathology?. Indian J Otol 2011; 17 (01) 8-11
  • 5 Grady D, Mathias P, Anderson R, Snider G, Sprinkle PM. Improvement of middle ear disease following septoplasty. Am J Otol 1983; 4 (04) 327-331
  • 6 Van Cauwenberge P, Derycke A. The relationship between nasal and middle ear pathology. Acta Otorhinolaryngol Belg 1983; 37 (06) 830-841
  • 7 Güçlü O, Sahin EM, Tekin K, Dereköy FS. Evaluation of nasal airways by objective methods in chronic otitis media. Eur Arch Otorhinolaryngol 2013; 270 (04) 1263-1266
  • 8 Singh A, Arora MML. Relationship between adenoids and chronic suppurative otitis media. Indian J Otolaryngol Head Neck Surg 1977; 29 (02) 69-71
  • 9 de Aquino JEAP, Zavarezzi DE, Carvalho MRMS, Aquino JNP. Endoscopic evaluation of pharyngeal orifice of eustachian tube in patients with chronic otitis. Int Arch Otorhinolaryngol 2007; 11 (02) 106-108
  • 10 Brook I, Yocum P, Shah K. Aerobic and anaerobic bacteriology of concurrent chronic otitis media with effusion and chronic sinusitis in children. Arch Otolaryngol Head Neck Surg 2000; 126 (02) 174-176
  • 11 Mills RP, Irani BS, Vaughan-Jones RJ, Padgham ND. Maxillary sinusitis in children with otitis media with effusion. J Laryngol Otol 1994; 108 (10) 842-844
  • 12 Rao BN, Reddy MS. Chronic suppurative otitis media—a prospective study. Indian J Otolaryngol Head Neck Surg 1994; 46 (02) 72-77
  • 13 Baruah PC, Agarwal SC, Arora MML, Mehra YN. Clinical and microbiological studies in suppurative otitis media in Chandigarh. Indian J Otolaryngol Head Neck Surg 1972; 24 (04) 157-160
  • 14 Grewal DS, Hiranandani NL, Pusalkar AG. The middle ear mucosa in chronic suppurative otitis media. Indian J Otolaryngol Head Neck Surg 1982; 34 (02) 1-5