Intra-operative findings of attico-antral type of chronic suppurative otitis media: A study of 85 patients.

Abstract

Objectives: Chronic suppurative otitis media is the most common ear disease in Otolaryngology OPD and Head & Neck surgery in tertiary care hospitals worldwide. Due to its life threatening complications and management difficulties, attico-antral disease, a type of CSOM poses a huge challenge to otolaryngologists. Study Design: Descriptive study. Setting: Department of Otolaryngology and Head & Neck Surgery Allied Hospital (FMU) Faisalabad. Period: From January 2016 to December 2018. Material & Methods: Eighty five patients with CSOM of attico-antral type were included. Results: Forty six patients (54.1%) were male and thirty nine patients (45.9%) were female, aged 07 to 58 years with an average age of 23.7 years. 42 patients (49.4%) had a right ear disease and 43 patients (50.6%) had a left ear disease. Granulation tissue was observed in 50 patients (58.8%), cholesteatoma in 27 patients (31.7%) and both granulation tissue and cholesteatoma in 08 patients (09.5%). The main pathology was observed to involve the attic area only of 04 patients (04.7%), attic and middle ear of 44 patients (51.7%), attic and antrum of 16 patients (18.9%) and attic, middle ear, antrum and other mastoid air cells in 21 cases (24.7%). The malleus handle was found eroded in 10 patients (11.8%), head & handle in only 02 patients (02.4%). In 23 patients (27%) long process of incus was damaged while incus was completely eroded in 03 patients (03.5%). The suprastructure of stapes was found eroded in 03 patients (03.5%). Conclusion: Granulation tissue is the most common primary lesion along with cholesteatoma associated with attico-antral type of CSOM. Due to this pathology, the incus is the most frequently eroded small bone of the middle ear. In addition the management of granulation tissue and cholesteatoma poses a huge challenge to the otolaryngologists. Therefore, the general practitioners are needed to be educated for early referral to otolaryngologist for early and rapid management to prevent complications due to attico-antral type of CSOM.