Tessema G
Yekatit 12 Hospital, P.O. Box 257, Addis Ababa.
Ethiop Med J. 2001 Apr;39(2):113-21.
Two thousand three hundred and thirty four selected patients with ear problem were seen in one of the ENT out patients department of Yekatit 12 Hospital from September 1994 to August 1996 were prospectively studied. Most of the patients came from Addis Ababa. Major clinical presentations were ear pain, purulent ear discharge, uni or bilateral decreased hearing ability. Patients were carefully evaluated by physical examination, otoscopy examination of the ear, schuilers view of the mastoid bone, audiometry findings and pus culture results. Diagnosis of these patients revealed that 1,630 (69.8%) had otitis while the rest 704 (30.16%) had other ear problems like ear wax, tinnitus and otitis external. One hundred two hundred thirty two patients (52.8%) had chronic otitis media with purulent discharge and decreased hearing ability, while 245 patients (10.5%) had chronic otitis media with out purulent discharge but with decreased hearing ability. Ninety six patients (4.1%) had acute otitis media and 57 patients (2.4%) had chronic seromucinous otitis media with decreased hearing ability. The micro-organisms identified include klebsiella spp. (28.97%), E. coli (10.7%), Citrobacter (3.6%), Acinetobacter (4.7%), S. aureus (3.57%), P. Valgaris (4.3%), S. Epidermidis (4.54%) and Dephtheroids (7.3%). Eighty nine patients with acute otitis media were completely cured and regained their hearing ability, the rest did not regain their hearing ability despite treatment. A combination of antibiotics and surgical treatment is recognized as the most effective intervention in this situation. The management of the chronic draining ear are: 1). To achieve a clean healed dry ear, 2) to obtain an air-containing middle ear space, 3) to rehabilitate hearing. The prevention of deafness and treatment of chronic draining ear disease especially in children is surgery which is not yet fully practiced in our centers.
1994年9月至1996年8月期间,对在耶卡蒂特12医院耳鼻喉科门诊就诊的2334例有耳部问题的患者进行了前瞻性研究。大多数患者来自亚的斯亚贝巴。主要临床表现为耳痛、脓性耳漏、单侧或双侧听力下降。通过体格检查、耳部耳镜检查、乳突骨舒勒氏位片、听力测定结果和脓液培养结果对患者进行了仔细评估。对这些患者的诊断显示,1630例(69.8%)患有中耳炎,其余704例(30.16%)有其他耳部问题,如耳垢、耳鸣和外耳道炎。1232例患者(52.8%)患有慢性化脓性中耳炎伴听力下降,而245例患者(10.5%)患有慢性非化脓性中耳炎但听力下降。96例患者(4.1%)患有急性中耳炎,57例患者(2.4%)患有慢性浆液性中耳炎伴听力下降。鉴定出的微生物包括克雷伯菌属(28.97%)、大肠杆菌(10.7%)、柠檬酸杆菌(3.6%)、不动杆菌(4.7%)、金黄色葡萄球菌(3.57%)、普通变形杆菌(4.3%)、表皮葡萄球菌(4.54%)和类白喉杆菌(7.3%)。89例急性中耳炎患者完全治愈并恢复了听力,其余患者尽管接受了治疗仍未恢复听力。抗生素和手术治疗相结合被认为是这种情况下最有效的干预措施。慢性流脓耳的治疗方法是:1)使耳部清洁、愈合、干燥;2)获得含气的中耳腔;3)恢复听力。预防耳聋和治疗慢性流脓耳疾病,尤其是儿童,手术是一种方法,但在我们的中心尚未得到充分应用。