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.
Keywords
otitis media - chronic disease - Eustachian tube - nose - throat
