Otitis Media: Does the Onus Lie on Sinonasal Pathology?

Abstract

Background: Although most of the literature refers to sinusitis and upper respiratory tract as causative factor of otitis media (OM), only few articles refer to actual nasal pathologies that can lead to it. Objective: To study the influence of sinonasal disease on the middle ear condition (OM). Material and Methods: 200 patients of otitis media attending ENT Services of teaching institution in Central India were included.In 340 ears detailed ENT examination was carried out. Results: Of the 200 patients of otitis media 50% had chronic suppurative otitis media tubotympanic type, 41% had retraction and remaining had cholesteatoma and otitis media with effusion. Sinonasal evaluation revealed deviated nasal septum in 80%, sinusitis in 13.5% and polyp in 10.5% patients. Multiple sinonasal pathologies were present in some patients. On treatment of sinonasal disease significant improvement of middle ear disease was found in 79.31% ears after septal correction (Wilcoxon Signed rank test, P<0.05), 82.35% ears after treatment of sinusitis and in 76.92% ears after polypectomy. Conclusion: On the basis of these results we recommend evaluation and treatment of sinonasal disease before surgical treatment of ear disease is undertaken.