Clinical and Audiological Characteristics of Chronic Suppurative Otitis Media in Al Muthanna Province Patients
Abstract
Background: Chronic suppurative otitis media (CSOM) is an ongoing inflammatory disorder of the middle ear characterized by recurrent or ongoing ear drainage through a perforated tympanic membrane. This disease is still a major public health problem in many developing countries, including Iraq. In Iraq, CSOM usually accompanies hearing loss and serious complications in the brain. Although CSOM is common in Iraq, there are very limited clinical and audiological data regarding patients afflicted by this disease in the current literature.
Objectives: This study aimed to explore the demographic, clinical, and audiological profiles of patients with CSOM who were seen at a tertiary referral hospital in southern Iraq. In addition, the study aimed to examine associations among different types of CSOM, duration of the disease, and hearing loss.
Methods: This prospective cross-sectional study was performed at the Ear, Nose, and Throat (ENT) outpatient department located within Al-Hussein Teaching Hospital in Samawa, Al-Muthanna Governorate, Iraq, from January 2020 through December 2022. A total of two-hundred fourteen subjects who met the diagnosis of CSOM were included in this study. Clinical evaluations, otoscopic examinations, microbiological culture of swabs, and audiometry testing were conducted on each subject. Data was analyzed via SPSS software version 26.
Results: The sample size included two-hundred fourteen patients (118 males, 96 females; mean age 28.4 ± 12.7 years). Incidence of CSOM was as follows: tubotympanic (safe) 147 patients (68.7%) and atticoantral (unsafe) 67 patients (31.3%). 38.3% of all subjects had bilateral disease. Otorrhea was the most frequently reported sign (100%) followed by hearing loss (87.4%) and otalgia (42.1%). The most common microorganism isolated on culture was Staphylococcus aureus (34.6%), followed by Pseudomonas aeruginosa (28.0%). Auditory testing indicated that the predominant type of hearing loss was conductive; the mean air-bone gap (ABG) for tubotympanic patients was 32.4 ± 9.8 dB and for atticoantral patients was 41.7 ± 11.2 dB (p < 0.001). Large central tympanic membrane perforations correlated with significant increases in hearing threshold levels.
Conclusion: The demographic and audiological profile of this sample of Iraqis with CSOM suggests that the disease is primarily present in young adult patients, most frequently as the tubotympanic type, and with a significant degree of conductive hearing loss. In addition, there are increased degrees of auditory impairment associated with the atticoantral form of CSOM than with the tubotympanic form. Early diagnosis, treatment directed at the underlying infection, and timely surgical intervention are essential to prevent additional auditory impairment in this population.
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References
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