Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Chronic Suppurative Otitis Media is a chronic inflammatory ear disease of middle ear cleft accounting for nearly 30% of the outpatient visits in practice of ENT. CSOM clinically presents with otorrhoea for more than 4 weeks, with defect in the tympanic membrane and hearing loss. Pathogenesis is a result of Eustachian tube dysfunction and impaired ventilation of the middle ear cleft resulting in permanent changes in the periosteum and mucosa of the mastoid antrum and air cells. The amount of discharge depends on these changes and further impairs the mechanism of ventilation of the cleft. As few papers are present in the literature highlighting the microscopic changes of tissue in CSOM, a study is conducted to observe the types of Histopathology in CSOM. Aim: To study the various Histopathological types of mucosa of middle ear cleft in CSOM cases. Materials and Methods: 76 patients undergoing mastoid exploration for the treatment of CSOM were included in the study. All the patients irrespective of active or inactive status of the ear disease were subjected to Mastoidectomy and sent for Histopathology. A single pathologist was asked to report all the specimens. The Histopathology reports are described depending upon the type of tissue, vascular pattern, infiltration of cells, presence or absence of Keratosis and giant cells. Observations and Results: Among the 76 patients 58 were females and 18 were males. 58 patients presented with Tubo-tympanic and 18 with Attico Antral type of CSOM. The commonest type of tissue pathology was reported as infected hypertrophied mucosa with infiltration of lymphocytes, plasma cells and occasional histiocytes in 44.82% of the Tubo-tympanic variety CSOM. Attico Antral type showed Cholesteatoma flakes (Keratosis) with vascular stroma infiltrated with inflammatory cells. Infiltration of chronic inflammatory cells was observed in 63.14% of the patients. Conclusions: Histopathological study in CSOM of both Tubo-tympanic and Attico Antral types varie. The HPE in the TT type principally shows granular leucocytes with hyperplasia of mucosa infiltrated and in few cases cholesterol granuloma formation or mucosal edema in others. Similarly, HPE of Attico Antral type showed vascular stroma infiltrated with inflammatory cells with cholesteatoma flakes (keratosis). Understanding the histopathological study, at the time of exploration of the mastoids in the surgical treatment of CSOM gives an insight to the necessity of clearance of the diseased mucosa from the auditus, antrum and air cells for the Tympanoplasty success.
How to cite this article:
P. Ashesh Reddy and P. Siva Subba Rao. Histopathological study of middle ear cleft mucosa in CSOM cases.
DOI: https://doi.org/10.36478/10.36478/makrjms.2024.7.331.335
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2024.7.331.335