Association of Tubotympanic Type Chronic Suppurative Otitis Media with Sinonasal Pathologies

Authors

  • Wasim Sajjad DHQ Teaching Hospital KDA Kohat, Pakistan.
  • Muhammad Zubair Khan Khyber Medical University Institute of Medical Sciences KDA DHQTH, Kohat,Pakistan.
  • Muhammad Saleem Khan Khyber Medical University Institute of Medical Sciences KDA DHQTH, Kohat,Pakistan.
  • Muhammad Aimen Ikram DHQ Teaching Hospital KDA, Kohat,Pakistan.
  • RahmatUllah khan PGR Hayatabad Medical Complex, Peshawar, Pakistan.
  • Furqan Ijaz DHQ Teaching Hospital KDA Kohat, Pakistan.

DOI:

https://doi.org/10.36283/ziun-pjmd14-3/041

Keywords:

Chronic suppurative otitis media, sino-nasal pathologies, association, complications

Abstract

Background: Sino-nasal and paranasal pathologies hurt the progression and treatment outcomes of chronic suppurative otitis media. The objective of this study is to find the association of chronic suppurative otitis media of the tubo-tympanic type with diseases of the nose and sinonasal system.

Methods: This was a prospective observational study with 110 patients involved through a consecutive non-probability sampling technique and conducted at Khyber Teaching Hospital, Peshawar, for a period of 6 months, starting from 1st July 2024 to 31st December 2024. The type of CSOM on otoscopy and various nasal pathologies seen on rhinoscopy were included. The presentation of CSOM on otoscopy and audiogram results with and without Sino-nasal disease was assessed. The Pearson chi-square test was used to test the correlation between risk factors (CSOM) and outcomes, with p-value <0.05 considered as statistically significant. 

Results: Out of 110 patients selected for this prospective trial, the mean age of the sample population was 25.6 ± 13.7. In terms of gender, 42 (38.2%) patients were female, and 68 (61.8%) patients were male. The Pearson chi-square analysis revealed a significant association between the absence of nasal pathology and symptoms of CSOM in terms of the health of the tympanic membrane and the level of hearing loss (p-value < 0.05); however, ear discharge had an insignificant correlation (p-value 0.652).

Conclusion: The study suggests that obstructive nasal and Sino-nasal conditions may negatively affect the response to treatment and worsen the symptoms related to chronic suppurative otitis media.

Author Biographies

  • Wasim Sajjad, DHQ Teaching Hospital KDA Kohat, Pakistan.

    Department of ENT,

  • Muhammad Aimen Ikram, DHQ Teaching Hospital KDA, Kohat,Pakistan.

    Department of ENT,

  • Furqan Ijaz, DHQ Teaching Hospital KDA Kohat, Pakistan.

    Department of ENT,

References

1. Dudapaka SR, Bhushan IP, Kondra S, Padmanabhan K. A study on influence of chronic sinusitis on mucosal active type of chronic otitis media in a tertiary care hospital, Hyderabad. *J Popul Ther Clin Pharmacol*. 2024;31(1):439–450.

2. Haqdad M, Aftab AA, Kumar A, Ali SS, Rai D, Ahmed N. Evaluation of complications and management of chronic suppurative otitis media: A retrospective study. *Pak J Med Health Sci*. 2022;16(5):461–3. doi:10.53350/pjmhs22165461

3. Agarwal V, Kumar L, Kalcheti G, Agarwal T, Agarwal P, Sharma D. Nosing around: Exploring the correlation between nose and ear lengths in the Indian population for reconstruction and prosthetic rehabilitation. *Indian J Otolaryngol Head Neck Surg*. 2025;77(2):949–951. doi:10.1007/s12070-024-05311-5

4. Atila EN, Topal K, Bulut YE, Kaya Z, Arslan B. Effects of nasal and paranasal sinus variations on chronic otitis media development in pediatric patients. *Eurasian J Med*. 2021;53(3):231–4. doi:10.5152/eurasianjmed.2021.20167

5. Brescia G, Frosolini A, Franz L, Daloiso A, Fantin F, Lovato A, et al. Chronic otitis media in patients with chronic rhinosinusitis: A systematic review. *Medicina (Kaunas)*. 2023;59(1):123. doi:10.3390/medicina59010123

6. 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):2695–8.

7. Chaudhry S, Ahmad Z, Khan FB, Afzal M. Frequency of otitis media in patients of nasal polypi. *J Ayub Med Coll Abbottabad*. 2010;22(2):83–5. PMID: 21702274

8. El-Antably A, Ateya K, Hamela MA, et al. Does Eustachian tube function affect the outcome of tympanoplasty? *Egypt J Otolaryngol*. 2021;37:65. doi:10.1186/s43163-021-00129-2

9. Sudiro M, Kuntara A, Waldi D. Correlation of Lund-Mackay score on computed tomography scan and nasoendoscopic score in chronic rhinosinusitis. *Acta Inform Med*. 2023;31(1):53–6. doi:10.5455/aim.2023.31.53-56

10. Casale J, Shumway KR, Hatcher JD. Physiology, Eustachian tube function. In: *StatPearls* [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 Jul 17]. Available from: [https://www.ncbi.nlm.nih.gov/books/NBK532284/](https://www.ncbi.nlm.nih.gov/books/NBK532284/)

11. Suryani L, Widuri A. Chronic suppurative otitis media characteristic in secondary hospital in Yogyakarta. *Open Access Maced J Med Sci*. 2022;10(T7):92–6. doi:10.3889/oamjms.2022.7860

12. Akhtar N, Haneef M, Naeem A. Chronic suppurative otitis media contributory factors and their prevention. *APMC*. 2020;14(3):209–13. doi:10.29054/apmc/2020.858

13. Masalha M, Shlizerman L, Mazzawi S, et al. Impact of otorrhea and positive cultures on tympanoplasty outcomes. *Isr Med Assoc J*. 2023;25(1):42–6.

14. Malpani SN, Deshmukh P. Deviated nasal septum: A risk factor for the occurrence of chronic rhinosinusitis. *Cureus*. 2022;14(10):e30261. doi:10.7759/cureus.30261

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. Alsaggaf ZH, Almadfaa AO, Marouf AA, et al. Sinusitis and its association with deviated nasal septum at a tertiary hospital: A retrospective study. *J Taibah Univ Med Sci*. 2022;17(6):1065–9. doi:10.1016/j.jtumed.2022.06.001

17. Goutaki M, Lam YT, Anagiotos A, et al. Definition of sinonasal and otological exacerbation in patients with primary ciliary dyskinesia: An expert consensus. *ERJ Open Res*. 2024;10(6):00218–2024. doi:10.1183/23120541.00218-2024

18. Yeolekar A, Dasgupta KS. Otitis media: Does the onus lie on sinonasal pathology? *Indian J Otol*. 2011;17:8–11. doi:10.4103/0971-7749.85784

19. 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;9:376–82.

20. Mittal R, Lisi CV, Gerring R, et al. Current concepts in the pathogenesis and treatment of chronic suppurative otitis media. *J Med Microbiol*. 2015;64(10):1103–16. doi:10.1099/jmm.0.000155

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Published

2025-07-21

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How to Cite

1.
Sajjad W, Khan MZ, Khan MS, Ikram MA, Khan R, Ijaz F. Association of Tubotympanic Type Chronic Suppurative Otitis Media with Sinonasal Pathologies. PJMD [Internet]. 2025 Jul. 21 [cited 2026 Jun. 4];14(3):264-9. Available from: https://ojs.zu.edu.pk/pjmd/article/view/3800

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