ABSTRACT
Mastoid operations have been in practice for over four centuries for suppurative conditions of the ear. Intact canal wall mastoidectomy has the advantage of rapid wound healing and also avoids frequent cleaning of the cavity. With canal wall down mastoidectomy there is excellent exposure for disease eradication and post-operative monitoring but is associated with significant cavity problems. In order to overcome the problems associated with canal wall down procedure while retaining its advantages, the concept of mastoid cavity obliteration was introduced. We wanted to study the outcomes of mastoid cavity obliteration and compare the outcomes of mastoid cavity obliteration with autologous cartilage as obliterating material for mastoid obliteration. METHODSA prospective, experimental, randomized study has been conducted over a period of 18 months among patients presenting with active squamosal variety of Chronic Otitis Media wherein 15 cases were allotted to each group which subsequently underwent canal wall down mastoidectomy followed by obliteration with autologous cartilage. RESULTSThe mean age of the individuals in group A is 25.47 years with a standard deviation of 8.89 years; in group B (obliteration with cartilage) it is 26.33 years with a standard deviation of 11.73 years. In group A, the mean duration required for complete epithelialization is 10.8 weeks while in group B, the average time taken for complete epithelialization is 5.07 weeks. All cases had their graft intact at the end of 12 weeks. Debris was present in group A for a mean duration of 9.47 weeks whereas in group B it is seen for a mean duration of 2.8 weeks. Patients from group A complained of discharge from their ears for a mean duration of 7.47 weeks. In group B the same symptom persisted over 2.8 weeks.
ABSTRACT
Background: The prevalence of chronic suppurative otitis media in children appears to be on the increase in our society probably due to factors associated with poverty and deteriorating healthcare facilities. This study aimed to determine the prevalence of chronic suppurative otitis media as seen in the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt with a view to documenting the pattern and highlighting the results of management. Patients and Methods: A retrospective study of all children that presented to the department of E.N.T surgery of UPTH, Port Harcourt, Nigeria with chronic suppurative otitis media over a tenyear period (January 2003-December 2012). The patient’s data were retrieved from the clinic registers, patients’ case notes and theatre registers. Demographic data, predisposing conditions, aetiological factors, site of tympanic membrane perforation, affected ear, treatment modalities, complications of treatment and outcome of management were recorded and analyzed. Results: Seven hundred and twenty three patients were found to have CSOM. These accounted for 9.4% of all otorhinolaryngological cases seen within the study period. There were 385 males and 338 females (male: female ratio of 1.1:1.0). Age range was 3 months to 16 years, mean = 8.2 +/- 3.2 years. Age group 1-5 years has the highest (n=344, 47.6%) number of cases. Bilateral CSOM accounted for the highest number (n=350, 48.4%) of cases. Perforation was found more on the antero inferior aspect of the tympanic membrane and the commonest etiological factor was poorly treated acute otitis media (AOM). The commonest mode of treatment was conservative medical treatment. Conclusion: This study confirmed a prevalence of 9.4% of CSOM in children that attended the ENT clinic in UPTH, Port Harcourt. The commonest type seen was the tubo-tympanic disease with antero-inferior tympanic membrane perforation. However, poorly treated AOM was found to be the commonest etiological factor. The provision of adequate health facilities and eradication of poverty possibly will reduce the prevalence of pediatric CSOM in our environment.