Relationship Between Chronic Suppurative Otitis Media And Cholesteatoma Of Middle Ear And Chronic Rhinosinusitis

Objective:To analyze the relationship between chronic suppurative otitis media(CSOM)and Cholesteatoma of middle ear(Chol)and chronic rhinosinusitis(CRS),so as to provide some reference for clinical work.Methods:A total of 403 patients with chronic suppurative otitis media and Cholesteatoma of middle ear who were hospitalized in the Department of Otolaryngology and Head and Neck Surgery in Yanbian University Hospital from October 2014 to December 2021 were collected,including 215 patients with chronic suppurative otitis media(CSOM group),188 cases of Cholesteatoma of middle ear(Chol group),166 patients with chronic rhinosinusitis hospitalized in our hospital(CRS group),and 148 patients diagnosed with sudden deafness(sudden deafness group).Record the disease course,age,gender,and hearing values(air conduction,bone conduction,and air-bone gap)of CSOM and Chol patients,and the disease course,age,and gender of CRS patients.CT scan of the middle ear to observe whether there is inflammation of the sinuses,and to consult in detail whether the patient has purulent nasal discharge,nasal congestion or headache symptoms and the duration of the symptoms and record them.Hearing loss and other symptoms and the duration of symptoms were recorded,and 55 patients with CSOM and CRS,44patients with Chol and CRS,and 11 patients with CRS and CSOM were obtained.Because it is difficult to obtain the head CT of the normal population,the patients with sudden deafness who can observe both the head CT and the middle ear without inflammatory diseases were simulated as normal people,and compared the CSOM group,the Chol group and the sudden deafness group.The incidence of CRS,and the duration of the disease in the CSOM group,the Chol group,and the CRS group.The disease course of CSOM and CRS in 55 patients with CSOM and CRS were compared,and the course of Chol in 44 patients with Chol and CRS was compared with the course of CRS.In 11 patients with CRS and CSOM,the course of CRS was compared with the course of CSOM,and the chronological order of CSOM,Chol and CRS was explored.The hearing(air conduction,bone conduction and air-bone gap)of CSOM patients with CRS and Chol patients were compared with those of CSOM patients without CRS and Chol patients,and the effect of CSOM and Chol with CRS on hearing was observed.Results:(1)Among the 403 CSOM and Chol patients,99(24.6%)were associated with CRS,including 55(25.6%)in CSOM,44(23.4%)in Chol,and there were 16patients(10.8%)with CRS in 148 sudden hearing loss patients.and the incidence of CRS between CSOM patients,Chol patients and sudden hearing loss patients was statistically significant(x~2=12.689,P<0.05).(2)The disease course of CSOM patients and Chol patients was generally longer than that of CRS patients.Among the 55 CSOM patients with CRS,there was a statistically significant difference between the CSOM and CRS disease courses(P<0.001).There was a statistically significant difference between the course of Chol and CRS(P<0.001),and among the 11 CRS patients with CSOM,there was no significant difference between the course of CRS and CSOM(P>0.05).(3)In CSOM patients,the difference of air conduction hearing threshold(Z=-0.305,P=0.760),bone conduction hearing threshold(Z=-0.254,P=0.800),and air-bone gap of patients with and without CRS(Z=-0.344,P=0.731)were not statistically significant(P>0.05).In Chol patients,the air conduction hearing threshold(Z=-0.896,P=0.370),bone conduction hearing threshold(Z=-1.411,P=0.158),and air-bone gap(Z=-1.411,P=0.158)between patients with and without(Z=-219,P=0.827)were not statistically significant(P>0.05).Conclusions:(1)CSOM and Chol patients are more prone to CRS than normal population.(2)The occurrence of CRS in CSOM patients with CRS and Chol patients with CRS may be related to CSOM and Chol.(3)Hearing loss in CSOM and Chol patients with or without CRS may not be significantly affected.