Abstract

Atticoantral (unsafe) chronic suppurative otitis media is one of the common conditions in otorhinolaryngology practice in developing countries. Its importance lies in the fact that it is associated with high morbidity and at times even with mortality. Method: Prospective comparative study conducted From July 2021 to June 2023 at tertiary care hospital .70 patients presenting to ENT OPD and casualty and getting operated for unsafe CSOM are included in the study. Demographic data, nature of ear discharge, and presence or absence of symptoms showing complications, otoscopic examination, hearing assessment by Pure tone Audiometry was noted. HRCT TEMPORAL BONE were advised to all the patients. Results: In our study the patients were between 5 to 66 years of age with mean age of 26.2 years, showed a male preponderance. the commonest complaint was otorrhoea (100%) Most, 68(97.14%) patients, presented with complaints of foul smelling discharge, Blood- stained discharge is often noted with granulation tissue or polyps and was presented by 31 (44.29%) patients, Tympanic membrane pathology was noted in 34 (48.57%) patients with perforation in 15 (21.42%) patients and retraction pockets in 19(27.14%) patients. Pre operative HRCT could diagnose soft tissue density suspicious of cholesteatoma in all 70 patients (100%).Bony erosion, an additional sign for the presence of cholesteatoma was identified in 25(35.71%) cases. HRCT was 100% sensitive for cholesteatoma in petrous apex followed by mastoid antrum 97.1 %, aditus 97 %,and epitympanum 94.9 %, HRCT to be 80% sensitive and 86.7 % specific in identifying ossicular destruction. Conclusions: Most common type of unsafe CSOM clinically found to have retraction pockets on otoscopy (primary acquired cholesteatoma.) Invention of HRCT has made remarkable improvements in the preoperative diagnosis of unsafe CSOM and its complications. But still false positive and false negative findings prevent complete dependence and reliability on HRCT.

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