Relationship between Septum Deviation Type and Radiologic Extent of Middle Ear and Mastoid Infection in CSOM
DOI:
https://doi.org/10.15395/mkb.v58.4630Keywords:
chronic suppurative otitis media, deviated septum, disease progressionAbstract
Chronic suppurative otitis media (CSOM) is a multifactorial inflammatory disease of the middle ear that may be influenced by chronic upper airway pathology, including nasal septum deviation, which can contribute to impaired ventilation of the Eustachian tube and persistence of infection. Several previous studies have demonstrated an association between CSOM and septal deviation. However, the relationship between specific types and directions of septum deviation and the radiologic extent of CSOM infection has not been clearly elucidated. This descriptive-analytical study evaluated medical record data from patients diagnosed with CSOM and nasal septum deviation at Dr. Hasan Sadikin Hospital Bandung, Indonesia, from 2023 to 2024. The radiologic extent of infection was evaluated using temporal bone CT scans and categorized based on the degree of middle ear and mastoid involvement, while the septum deviation type was determined according to the Mladina classification and its direction was also recorded. A total of 35 patients met the inclusion criteria. Most patients (80%) demonstrated grade 3 radiologic involvement, and Mladina type 2 was identified as the most common septal deviation pattern. Despite the predominance of certain deviation types in patients with higher radiologic grades, statistical analysis revealed no significant relationship between septum deviation type or direction and the degree of radiologic CSOM involvement (p>0.05). These findings suggest that, although septum deviation is frequently observed in patients with CSOM, its specific type and direction are not significantly associated with the extent of radiologic infection involvement in this study population.
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References
1. Al-Qahtani A, Hadiar H, Larem A. Textbook of clinical otolaryngology. Cham (Switzerland): Springer Nature Switzerland AG; 2021.
2. Bhutta MF, Leach AJ, Brennan-Jones CG. Chronic suppurative otitis media. Lancet. 2024;403(10441):2339–48. doi:10.1016/S0140-6736(24)00259-9
3. Nurafni, Pratama AA, Ellistrika WO, Darma S, Vivaldi R. Prevalensi karakteristik pasien OMSK dewasa dan anak di RSUD Sayang Rakyat periode Januari-Desember 2021. J Mhs Kedokt. 2022;2(5):359–67.
4. Atiyah A, Saadi Majeed N. Unilateral chronic suppurative otitis media: effect of nasal septal deviation. Int J Adv Res. 2021;9(3):122–6.
5. Sistani SS, Dashipour A, Jafari L, Ghahderijani BH. The possible associations of nasal septal deviation with mastoid pneumatization and chronic otitis. Open Access Maced J Med Sci. 2019;7(15):2452–6. Published 2019 Aug 8. doi:10.3889/oamjms.2019.670
6. Shrestha KK, Dhungana A, Rijal AS, Joshi RR, Shrestha S, Karki S. Association between deviated nasal septum and function of eustachian tube among patients attending a tertiary care center. J Nepal Health Res Counc. 2024;26:217–21. doi:10.3126/nmcj.v26i3.69882
7. Jain S, Bhalerao P, Singh C. A new endoscopic and anatomical classification of deviated nasal septum with clinical relevance. Med Sci. 2020;24(104):24–30.
8. Shankar SS, Shettigar NP. Correlation between chronic suppurative otitis media and deviated nasal septum of the ipsilateral side. Int J Otorhinolaryngol Head Neck Surg. 2023;9(5):376–82.
9. Havle AD, Basha MK, Pincha N, Prabhune SC. A cross-sectional study of tubotympanic chronic suppurative otitis media with reference to sinonasal pathology. J Evol Med Dent Sci. 2020;9(37):2695–9.
10. Parmar BD, Jha S, Sinha V, Chaudhury N, Dave G. A study of complications of chronic suppurative otitis media at a tertiary care hospital. Int J Otorhinolaryngol Head Neck Surg. 2020;6(2):330–4. doi: 10.18203/issn.2454-5929.ijohns20200146
11. Kombade SP, Kaur N, Patro SK, Nag VL. Clinico-bacteriological and antibiotic drug resistance profile of chronic suppurative otitis media at a tertiary care hospital in western Rajasthan. J Fam Med Prim Care. 2021;10(7):2572–9.
12. Islam MS, Ahmed MB, Khan N, Asaduzzaman A. Sociodemographic factors of atticoantral chronic suppurative otitis media. Bangladesh J Otorhinolaryngol. 2020;26(2):136–41.
13. Alotaibi AD, Almutlaq BA, Alshammari FN, Gadelkarim Ahmed H. The common clinical presentation of patients selected for septoplasty in northern Saudi Arabia. Int J Otolaryngol. 2018;2018:3940368. doi:10.1155/2018/3940368
14. Choi SY, Jeon SY, Rim HS, Kim SW, Min JY. Nasal septal deviation and incidental paranasal sinus opacification: a role of computed tomography. J Rhinol. 2021;28(1):50–6.
15. Rao N, Datta G, Singh G. To study the role of nasal septal deviation and its relation to sinonasal pathology. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 2):755–9. doi:10.1007/s12070-020-01800-5
16. Hidayat R. Pathophysiological to clinical aspects of chronic suppurative otitis media (CSOM): narrative literature review. Arch Med Case Rep. 2022;3(2):246–55.
17. Jain S, Deshmukh P. A review on deviated nasal septum: classification, clinical features and management. J Pharm Res Int. 2021; 33(60A):432–7. doi: 10.9734/jpri/2021/v33i60A34504.
18. Rahman MM, Parveen S, Alam SS. Association of deviated nasal septum with chronic otitis media. Sch J Appl Med Sci. 2024;12(3):308–11. doi:10.3126/jobh.v2i1.94671
19. Aladeyelu OS, Olaniyi KS, Olojede SO, Mbatha WBE, Sibiya AL, Rennie CO. Temporal bone pneumatization: a scoping review on the growth and size of mastoid air cell system with age. PLoS One. 2022;17(6):e0269360. doi:10.1371/journal.pone.0269360
20. Khalique N, Ahmad Z, Chandra K, Zubair Y. Clinico-epidemiological study of safe and unsafe chronic suppurative otitis media. Indian J Otolaryngol Head Neck Surg. 2022;34(1):106–10. doi: 10.47203/IJCH.2022.v34i01.020
21. Verma P, Gargava A. To study the prevalence of extracranial and intracranial complications in chronic suppurative otitis media. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 1):608–11. doi:10.1007/s12070-021-02423-0
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