Care of Chronic Suppurative Otitis Media (CSOM)

K. Marilakshmi

Nurse Educator, Kauvery Hospital, Tirunelveli

Otitis-Media

Abstract

CSOM is one of the common diseases in otorhinolaryngology practice today. CSOM is more common in developing countries. In our country burden of the disease is very high considering the huge population. Prevalence of CSOM in the world is around 65-330 million/year. Majority of the world CSOM burden is borne by Southeast Asia, Western pacific and African countries. India falls into countries with highest prevalence (prevalence – 4%). CSOM is more common in low socio-economic status groups, communities with overcrowding and poor personal hygiene. Incidence of CSOM has been declining due to improvement in living conditions and use of widespread antimicrobial therapy. However still many patients cannot afford treatment because of economic constraints. Scarcity of qualified surgeons forces these patients to take medical advice from local unqualified persons or sometimes they resort to self-medication. This makes them vulnerable to develop complications of CSOM. Lack of awareness and not attending hospitals are probably because of ignorance, poverty and traditional beliefs.

Background

A 27- years- aged male patient came with the complaints of right ear otorrhagia (discharge) associated with minimal hearing loss. After collecting history, the consultant did examination and investigations, and planned for mastoidectomy with tympanoplasty.

Patient had a past history of CSOM two years back. At that time, he took treatment from outside. Now the patient needed for right mastoidectomy with tympanoplasty. He doesn’t have any other past history. He has no previous surgical history.

Examination

The patient is conscious, oriented, and afebrile. PR: 120 beats\mts, BP: 120\80 mmhg, CVS: S1, S2 present, RS: Bilateral air entry is present, P|A: soft, non-tender, CNS: NFND

Surgery:

Patient underwent a mastoidectomy with tympanoplasty. Relevant preoperative investigations done for the patient outside. After prior preparation on day 29/07/20203 under the general anesthesia the procedure was done by the consultant. Post-operative vitals were stable. Patient was treated with IV fluids, antibiotics, analgesics. On the third post-operative day, dressing was changed; healthy surgical wound was seen.

Medications

  1. Tab. Augmentin-625mg-BD
  2. Tab. voviran-50 mg- HS
  3. Tab. Relent-Hs

Diet advice

Normal diet as well as the balanced diet.

Diet-advice

Nursing management

  1. Positioning: Have the patient sit up, raise head on pillows, or lie on unaffected ear.
  2. Heat application.Apply heating pad or awarm hot water bottle.
  3. Hygiene.Teach family members to cover mouths and noses when sneezing orcoughingand to wash hands frequently.
  4. Monitoring hearing loss.Assess hearing ability frequently.

Outcome

On the day of discharge patient was hemodynamically stable.

Marilakshmi

Ms. K. Marilakshmi

Nurse Educator

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