A HOSPITAL-BASED CLINICAL STUDY ON THE MANAGEMENT OF CHRONIC MASTOIDITIS AND MASTOID ABSCESS AT VIMS, PAWAPURI, NALANDA, BIHAR

Abstract

Background: In spite of the advent of antibiotics, the incidence of mastoiditis and mastoid abscess is not uncommon in the ENT practice. The pathogenesis is due to virulence of organism, insufcient antibiotics use, and ineffective antibiotics. Treatment consists of simple incision drainage to modied radical mastoidectomy. However, there seems to be no unanimous agreement on the best management strategy for this problem. The present study presents the outcome of patients undergoing treatment and also presents a protocol followed in VIMS, Pawapuri, Nalanda, Bihar and its prognostic value. Aim of the Study: The aim of this study is to review the available management protocols for treatment of mastoiditis and mastoid abscess and formulate our own hospital-based guidelines and protocol. Materials and Methods:Astudy was conducted on 53 patients aged between 11 and 60 years, who presented with mastoiditis or mastoid abscess. All the patients were treated according to surgical protocols available. Demographic data, history, and otoscopy ndings were recorded. Patients with mastoiditis were treated with mastoidectomy, and the patients with mastoid abscess were treated initially with incision and drainage and after 2 weeks with mastoidectomy. Laboratory investigations such as audiometry, culture, and sensitivity of pus from the ears were done. All the patients were followed for 6 months. Observations and Results:Atotal of 53 patients were enrolled in this study. Mean age was 25.45 ± 2.35 in males and 23.76 ± 1.85 in females who presented with mastoiditis. Similarly, the mean age was 23.76 ± 1.85 and 20.46 ± 2.10 years for patients of mastoid abscess. There were 39/53 (73.58%) males and 14/53 (26.41%) females. Audiometry could be done in 32/37 (86.48%) patients with mastoiditis and 8/16 (50%) patients with mastoid abscess. These 40/56 (71.42%) patients had conductive deafness with a mean pure tone average of 32.45 dB. There were no post-operative complications reported during follow-up of 6 months. Conclusions:Adenitive management protocol is a must for every hospital to avoid delay and complications before and after surgical treatment in mastoiditis and mastoid abscess. Treatment guidelines should be followed meticulously in the diagnosis, laboratory investigations, and decisionmaking of denitive surgical procedure to be adopted in mastoiditis and mastoid abscess.