Chronic Suppurative Otitis Media Atticoantral- Type Undergone Canal Wall Down Mastoidectomy in a Peripheral Government Hospital of Nepal

Abstract

Introduction: Chronic suppurative otitis media is a severe type of chronic ear infection which is quite common in all geographical situations of Nepal. The mainstay of treatment of this disease is surgery, preferably of canal down method. The objective of the study was to identify the common presentation(s) and the clinical and operative finding(s) in patients with chronic suppurative otitis media attico-antral type and evaluation of efficacy of canal-wall down mastoidectomy in the achievement of dry ear and change in hearing in a setting of a peripheral hospital of Nepal in terms of subjectivity. Per-operative evaluation of mastoid cavities in terms of types of pathologies and post- operative assessment of ears in terms of achieving a dryness and change in hearing ability was carried out in the ENT Department, Bharatpur Hospital , Chitwan, Nepal. Study was done from January 2005 to December 2010. Methods: Seventy three patients with chronic suppurative otitis media atticoantral- type were evaluated preoperatively in terms of gross pathologies. Postoperatively, patients were subjectively evaluated twice in six months in reference to persistent ear discharge and change in hearing ability. Results: By six months of surgery, 75% of the patients had no discharge. Fifty two patients did not experience any change in hearing ability. Only 16% experienced betterment in hearing while 19% had diminution in hearing. Conclusions: Canal wall down mastoidectomies are very effective in controlling otorrhoea and complications related to chronic suppurative otitis media attico-antral type.  Keywords: Chronic suppurative otitis media attico-antral (CSOM-AA) type; CWD masoidectomy; CWU mastoidectomy; ear cavity.