ABSTRACT
INTRODUCTION: Perforation of tympanic membrane constitutes a major portion of patients attending ENT OPD for which they are advised surgical procedures. Most of the cases with small perforations can be managed by doing OPD procedure of cautery patching and hence surgical procedure can be avoided. METHODS: The study was conducted in the tertiary hospital from August 2018 to July 2019. The patients were selected on the basis of the inclusion criteria after doing clinical examination, and audiometry. All the patients underwent cautery patching with tincture ferri perchloride and patch placed. The patients were followed up weekly till the perforation was completely closed or uptill 3 months. RESULTS: Total of 65 patients was included in the study. Most common etiology of perforation was inflammatory involving anteroinferior quadrant as most common etiology with success achieved in 56 patients. CONCLUSION: patients with small central dry perforation of tympanic membrane, cautery patching using tincture ferri per chloride and paper patching gives good results comparing to the surgical procedure, while ablating the morbidity and psychological trauma of the surgery.
ABSTRACT
Background: Chronic suppurative otitis media (CSOM) is a commonly encountered infection of the middle ear. It cancause extra cranial and intracranial complications and involves considerable morbidity. Although it is a global disease, its incidence has remained relatively higher in resource-constrained countries. Due to its recurrent nature and the development of resistant pathogenic organisms, control of infection poses a greatest therapeutic challenge. Knowledge of the local microbial flora in CSOM is essential for initiating empirical therapy. The objective of our study was to examine the current bacteriological profile and antibiotic sensitivity pattern to locally available antibiotics in CSOM. Methods: A total of 157 patients clinically diagnosed of CSOM were enrolled in the study and the samples were obtained from each patient using sterile cotton swabs and were processed as per standard microbiological techniques. Antibiotic sensitivity to ten locally available antibiotics was analyzed. Antibiotic susceptibility testing for bacterial isolates was conducted using Kirby-Bauer disc diffusion method. Results: Out of total 157 swabs bacterial growth was seen in 144 (91.72%) with Pseudomonas aeruginosa (28.5%) and Staphylococcus aureus (22.9%) being the most common bacterial isolates. Among the antibiotics tested amikacin (88.3%), ciprofloxacin (78.9%) and cotrimoxazole (78.2%) were found to be most active against all the isolates, whereas maximum resistance was seen for ampicillin (45.8%). Poor hygiene 79 (50.3%) and pond/river bath 51 (32.5%) were the two most common predisposing factors associated with CSOM. Conclusion: In the era of continuously increasing drug resistance among bacteria, periodic monitoring of the bacterial isolates causing CSOM and their antibiogram with clinical correlation is very important. Local antimicrobial susceptibility data should be utilized for formulating antibiotic policy for every institution. Our results will surely help in the modification of hospital’s current antibiotic policy and also will optimize the therapy to patients.