VARIATIONS IN CLINICAL PRESENTATION OF CHRONIC SUPPURATIVE OTITIS MEDIA

Introduction: Chronic suppurative otitis media is persistent inflammation of the middle ear or mastoid air cells, clinically manifested with deafness and ear discharge. Hearing disability in adults and children also has its bearing on the individual and on the society. Chronic suppurative otitis media is fairly common disease especially in rural community .Chronic suppurative otitis media remains the most common cause of hearing impairment. The hearing loss is usually conductive resulting from tympanic membrane rupture and or changes in the ossicular chain due to fixation or erosion caused by chronic inflammatory process.The chronic inflammatory process can produce some circulatory disturbance such as vasodilation and vasoconstriction of the mucosal vessels of the round window membrane which could influence the inner ear. Toxins cross the round window membrane and cause irreversible cochlear hair cell loss mostly effecting the basal turn of cochlea. The relationship between chronic suppurative otitis media and sensorineural hearing loss remains a controversial issue.Sensorineural hearing loss due chronic otitis media has been reported as a definite pathologic entity, but its prevalence remains controversial. R Sharma and VK Sharma reported that in CSOM frequency of SNHL is 13% while Kamajit kaur reported 24% frequency of SNHL in CSOM .The Study also provides literature with magnitudes in local population . Objective: To determine the frequency of sensorineural hearing loss in chronic suppurative otitis media . Study design: Cross-sectional study . Settings : ENT department Shaikh Zayed Hospital Lahore . Duration with date: From Nov 01, 2017 to May 22, 2018 Subjects And Methods: Sample size: The sample size of 180 was estimated by using 95% confidence level and 5% margin of error with expected frequency of sensorineural hearing loss 13%6 among cases with chronic suppurative otitis media. Sampling technique: Non probability purposive sampling Results : The age range was 10 to 50 years for both male and female.The male patient were 114 (63.3%) and 66 (36.7%) patient were female .Out of these patients 137 (76.1%) have tubotympanic CSOM and 43 (23.95%) have atticoantral CSOM.23 (12.8%) patients have sensorineural hearing loss and 157(87.2%) patients do not have sensorineural hearing loss.Out of 180 patients 99(55%) have moderate hearing loss on pure tone audiometry. Conclusions : It is concluded from the study that majority of patient with CSOM have tubotympanic type and while a less percentage of patients have atticoantral type .Males are effected more than males .The incidence of sensorineural hearing loss (12.8%) in CSOM is much lower than the conductive hearing loss. Key words: Chronic suppurative otitis media ,sensorineural hearing loss, pure tone audiometry