Surgical management of chronic suppurative otitis media: A 3-year experience

Abstract

Background/Objective : To determine the outcome of surgery for chronic suppurative otitis media at our department over 3 years, between 2001 and 2003. The outcome measures were; achievement of dry ear, closure of tympanic membrane perforation and improvement in hearing for patients who had myringoplasty. Methods : A retrospective review of case notes of patients with chronic suppurative otitis media (cholesteatoma and non-cholesteatomatous disease) operated upon by 2 consultant ENT surgeons in our department over a 3 year period. The operations performed were mastoidectomy and type I tympanoplasty or myringoplasty. The results were analysed and presented. Results : Seventy three patients were operated upon for cholesteatoma and non-cholesteatomatous chronic otitis media during this period, there were 41 males and 32 females with a sex ratio of 1:1.3. Age range was 9 to 84 years with the mean age of 37 years. 17 of them were children aged 9 to 15 years (24%). 25 patients (34.2%) had cholesteatoma and 48 (65.8%) had non-cholesteatomatous disease 41 (56.2%) had myringoplasty and 29 (39.7%) had mastoidectomy, and 3 (4.1%) patients had tympanomastoidectomy. 62.5% (n=20) mastoid cavities were dry at 12 months follow up. Perforation closure was achieved in 89% (n=34). Binaural hearing was achieved in 6 patients and in 4 patients the operated ear became the better hearing ear; air-bone gap was closed completely in 8 patients (19.5%), and in 36.6% (n=15) the gap was closed to within 10dB. There was no deterioration in hearing in the operated ears. One patient presented with House Brachman grade 2 facial palsy pre-operatively which worsened to grade 4 post operatively but improved to pre-operative grade at 12month follow up. Conclusion : Chronic suppurative otitis media is a disease that is still with us, and at our department, the surgery has a high success rate, which is also comparable in adults and children. Keywords : cholesteatoma, non-cholesteatomatous otitis media, tympanoplasty, surgery, outcome Annals of African Medicine Vol. 5 (1) 2006: 24–27