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A Study on Chronic Otitis Media Active Mucosal Type With Sinusitis as Focal Sepsis

AIM : To establish the role of Sinusitis as Focal sepsis in Chronic Otitis media active mucosal disease, to emphasize the need of proper diagnostic endoscopic evaluation and improvement in middle ear mucosal disease status after functional endoscopic sinus surgery.

METHODS : 60 Patients in the age groups of 18-49 years Chronic otitis media active mucosal disease were identified and screened for evidence of Focal Sepsis in Pasanasal sinus by Diagnostic Nasal endoscopy and computed tomography of paranasal diseases. Then Functional endoscopic sinus surgery was done to clear sinusitis and middle ear mucosal disease status assessed.

RESULTS :Evaluation revealed that sinusitis in these patients was the cause for persistent discharge. All patients had one or more evidence of sinusitis like pus in middle meatus, deviated nasal septum and turbinoseptal deformities, prominent enlarged bullae, enlarged middle turbinate on DNE and CT. The otoendoscopy showed inflamed and boggy middle ear mucosal status. All patients underwent septoplasty/FESS depending on findings. Out of 60 patients 52 patient had improvement in middle ear mucosal status with surgery.

CONCLUSION :In the adult population sinusitis is the most important focal sepsis in case of persistent ear discharge in Chronic Otitis Media active mucosal type of disease.A proper diagnostic nasal evaluation of all Chronic Otitis Media active mucosal type of patients is necessary in comprehensive management of the disease. The clearance of sinusitis has improved the middle ear mucosal status. Unilateral ear discharge is associated with sinusitis only on the corresponding side, which is in concurrence with our study. Functional endoscopic sinus surgery has emerged as the best procedure for clearance of sinusitis.

Author(s): Sankaranaryanan Gopalakrishnan, Satheesh kumar