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慢性中耳炎的并发症、鼻窦易患因素及微生物学特征研究

A Study of Complications, Sinonasal Predispositions and Microbiological Profile of Chronic Otitis Media.

作者信息

Ahmad Zeeshan, Zubair Mohd Yasir, Chandra Kamlesh, Khalique Najam

机构信息

Department of Otorhinolaryngology, Jawahar Lal Nehru Medical College, AMU, Aligarh, 202002 India.

Department of Community Medicine, Jawahar Lal Nehru Medical College, AMU, Aligarh, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2023 Apr;75(Suppl 1):403-408. doi: 10.1007/s12070-023-03512-y. Epub 2023 Feb 3.

Abstract

Keeping in view the changing flora of chronic otitis media (COM), geographical variability of its complications and differential prevalence of sinonasal predisposing diseases in these patients, we studied the microbiological profile along with the complications and sino-nasal diseases in patients with COM. It was a Cross-sectional study conducted during Nov 2017 to Dec 2019 in department of Otorhinolaryngology, Jawaharlal Nehru Medical College, AMU, Aligarh. The study included 200 cases of chronic suppurative otitis media, both Mucosal (safe) and Squamous (unsafe) type, out of which 111 (55.5%) were males and 89 (44.5%) were females. The overall prevalence of complications in patients with COM in our study was high at 6.5% with 61.54% complications being extracranial and 38.46% were intracranial. DNS was the most common sino-nasal disease found in 22.5% of patients followed by Inferior turbinate hypertrophy, Adenoid hypertrophy and polyp in 6.5%, 5.5% and 4% of participants respectively. A culture positive result was found in 84.5% of the samples with 55.5% samples being monomicrobial and 29.0% being polymicrobial. COM like the other chronic diseases impacts quality of life. As long as health-care delivery fails to target high-risk groups in developing countries such as ours infections like CSOM will persist with its adverse consequences. With the development and widespread use of antibiotics, the types of pathogenic micro-organisms and their sensitivity to antibiotics have changed. Continuous evaluation of pattern and antibiotic sensitivity of isolates is necessary to decrease the potential risk of complications by early institution of appropriate treatment.

摘要

鉴于慢性中耳炎(COM)的菌群不断变化、其并发症的地理变异性以及这些患者鼻窦易感疾病的差异患病率,我们研究了COM患者的微生物学特征以及并发症和鼻窦疾病。这是一项于2017年11月至2019年12月在阿利加尔穆斯林大学贾瓦哈拉尔尼赫鲁医学院耳鼻喉科进行的横断面研究。该研究纳入了200例慢性化脓性中耳炎患者,包括黏膜型(安全型)和鳞状型(不安全型),其中111例(55.5%)为男性,89例(44.5%)为女性。在我们的研究中,COM患者并发症的总体患病率较高,为6.5%,其中61.54%的并发症为颅外并发症,38.46%为颅内并发症。DNS是最常见的鼻窦疾病,在22.5%的患者中发现,其次是下鼻甲肥大、腺样体肥大和息肉,分别在6.5%、5.5%和4%的参与者中发现。84.5%的样本培养结果呈阳性,其中55.5%的样本为单一微生物感染,29.0%为多微生物感染。COM与其他慢性疾病一样会影响生活质量。只要像我们这样的发展中国家的医疗服务未能针对高危人群,则像慢性化脓性中耳炎这样的感染及其不良后果将持续存在。随着抗生素的发展和广泛使用,致病微生物的类型及其对抗生素的敏感性已经发生了变化。持续评估分离株的模式和抗生素敏感性对于通过早期给予适当治疗来降低并发症的潜在风险是必要的。

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