ABSTRACT
During the five-year period from 1998 to 2002, the ENT department of the University Clinic of Kinshasa treated 343 patients suffering from chronic suppurative otitis media (CSOM) and complications. Two hundred and seven patients had simple, 28 had cholesteatomatous form of CSOM, and 108 patients presented with intratemporal or intracranial complications. Roughly half of the patient group consisted of children younger than 10 years. The simple form of CSOM affects men and women equally, but the cholesteatomatous form was more prevalent among men. Otorrhoea and hearing loss were the major presenting symptoms. Hearing loss was moderate to severe in 2/3 and slight in 1/3 of the audiometrically tested ears. A mastoidectomy was performed on 55% of the patients. Roughly 1/3 of the patients presented with complications, the majority of which (69) were subperiostal abscesses. Complications other than subperiostal abscesses were associated with a high morbitidy and a few patients even died. Our data suggest that the prevalence of CSOM in the Kinshasa area is at least 4% and, in fact, has not declined over the last 20 years.
Subject(s)
Otitis Media, Suppurative/complications , Otitis Media, Suppurative/epidemiology , Academic Medical Centers , Adolescent , Adult , Age Distribution , Brain Abscess/etiology , Child , Child, Preschool , Cholesteatoma/etiology , Chronic Disease , Cohort Studies , Democratic Republic of the Congo/epidemiology , Female , Hearing Loss/etiology , Humans , Infant , Male , Mastoiditis/etiology , Meningitis/etiology , Middle Aged , Retrospective Studies , Sex Distribution , Tympanic Membrane Perforation/etiologyABSTRACT
AIM: The study intended to identify bacteria active in the chronic suppurative otitis media and to determine their sensitivity to current antibiotics. METHODS: After clinical evaluation, middle-ear secretions were taken for bacteriological examination from 78 children meeting the inclusion criteria. All children with cholesteatoma and those with tumors occluding the ear canal were excluded. RESULTS: The most frequent isolated germs, in descending order frequency, were as follows: Proteus mirabilis (23%), Pseudomonas aeruginosa (22%), Citrobacter (20%) and Salmonella (5%). There were no cases of mixed flora. Ofloxacin was susceptible on all isolates. Neomycin, gentamicin and polymyxin B were susceptible on 96%, 83% and 67% of the isolates respectively. All isolates were resistant to amoxycillin. CONCLUSION: Peudomonas, Proteus and Citrobacter are the most common causes of chronic otitis media among children in our community of congolese children. Ofloxacin and neomycin are the most highly effective against most of the isolated germs, and are therefore recommended as the first line local treatment. Amoxycillin and chloramphenicol should be avoided.
