Pattern of Chronic Suppurative Otitis Media at the National Ear Care Centre Kaduna, Nigeria
AbstractBackground: Chronic suppurative otitis media constitutes a major cause of otorhinolaryngological clinic visits in Nigeria, therefore it is pertinent to determine the local pattern of presentation in order to achieve adequate treatment, avoid complications and provide records for future references.
Methodology: A retrospective review of patients presenting with chronic suppurative otitis media to the out-patient clinic of the National Ear Care Center, Kaduna within a period of 1 year.
Results: One hundred and forty six patients presented, accounting for 3.8% of the total number of patients and 6.6% of all otological cases. One hundred and twenty eight (87.7%) case notes were retrievable and studied. Patients were aged 1 year to 82 years (mean=19.2 years) with 67 males and 61 females giving a gender ratio of 1.1:1. Children under 10 years constituted the majority (n=64). Tympanic membrane perforation was central in 117 (67.6%), marginal in 38 (22%) and attic in 18
(10.4%) patients. Positive culture occurred in 75 (58.6%), no growth in 22 (17.2%) patients and there was no record of ear swab or culture in 31 (24.2%) patients. Bacterial isolates were Klebsiella specie (n=31, 41.3%), Escherichia coli (n=22, 29.3%), Streptococcus specie (n= 8, 10.8%), Staphylococcus aureus (n=7, 9.3%), Pseudomonas aeruginosa (n=6, 8%) and Proteus specie (n=1, 1.3%). Antimicrobial sensitivity was highest to the quinolones (57.9%). Ninety-four (73.4%) patients achieved dry ears in the first month. The complication rate was 6.3%.
Conclusion: We recommend the quinolone antibiotics as first line drugs in treatment of chronic suppurative otitis media and continuing medical education of general practitioners and pediatricians especially those practicing in the rural areas on the management of CSOM is important to improve the outcome.