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N =120 40-- [_ M 30 - - @ F _ 54.1% r f, 2010- - 10% ,-,.,"" ,,-,'"""": _jj ¢1a4, _35.8'_ , • r/J C P CL CL+CP alone alone Fig. 2 I. Family H. (+) II. Maternal H. '_--_-----"-- _"_-E__:_e_.,_ , - 57% Illness I 1.7% j, Trauma 12.7% Medications _ 6.3% Ill.F.H. or M.H.'(-) _19.8% 10 20 30 40 50 60 Fig. 3 57
UNIVERSITY PHILIPPINE DEPARTMENT OF THE PHILIPPINES GENERAL HOSPITAL OF OTOLARYNGOLOGY TITLE:MICROBIALFLORAIN CHRONICOTITISMEDIA:VALUEOFEARASPIRATE CULTURESTUDIES AUTHORS:Rhodoradel Rosario,MD CharlotteM. Chiong,MD AbnerL. Chan,MD EditaC. Yap, MD JoselitoC. Jamir,MD GenerosoT. Abes,MD ABSTRACT A comparative study was done to compare the , microbiology of the ear aspirate to the contents in the Culture and sensitivity studies on ear aspirate, middle ear cleft namely, cholesteatoma, bone and cholesteatoma, bone and granulation tissue were granulation tissue. The organisms were likewise done on 30 patients with chronic otitis media who identified andthe sensitivity pattern of the commonly underwent radical mastoidectomy. The most com- isolated organisms were determined. mon organisms isolated were Proteus mirabilis,Proteus vulgaris and Pseudomonas aeruginosa. All three showed a 100% sensitivity to ampicillin, trimethoprim, MATERIALS AND METHODS chloramphenicol and cephalexin, Bacteroides, an anaerobic organisms, was grown in only 4/100 Thirty patients with chronic otitis media, 20 males isolates. Cultures from the transcanal aspirates were and ten females with age range 6-45 years (Table 1) compared to those obtained directly from the middle seen at the ENT Dept. who underwent radical masear. Computation of the positive predictive value toidectomy were included in the study. Culture showed that the transcanal aspirate showed a good and sensitivity studies were done on ear aspirate, excellent correlation for the three most common cholesteatoma, bone and granulation tissue specimens. organisms cultured. Ear discharge was aspirated aseptically after the ear canal was swabbed with aloohol soaked cotton. The INTRODUCTION other specimens were collected intraoperatively. All _ were immediately placed in thioglycolate media. These Chronic otitis media (COM) is a common problem were then inoculated in blood agar plate (BAP), and encountered in the ENT clinic. It is an insidious Mac Conkey agar plate. Incubation at 37 C for 24 and potentially destructive disease characterized by hours was done after which the plates were read. the presence of intractable mucosal, submucosal and/ Colonies were identified by their morphologic and or bone pathology of the middle cleft. In this biochemical characteristics. Antibiotic susceptabilinstitution, 60% of 269 ears operated on during the ity of the aerobic isolates to various drugs were year 1989 were for chronically discharging ears. Inspite tested using standard Kirby-Bauer method. For the of the prevalence of the disease, antibiotic treatment anaerobic culture, the specimen from the thioglycote is still largely empirical as a culture and sensitivity medium were inoculated in a fresh blood agar plate studies are not routinely done. One method of under gas Pak method. If the isolates were the same obtaining specimen for culture in the clinic is by as those found in the aerobic culture, no further transcanal aspiration of ear discharge. However, it susceptibility studies were done. However if the is yet to be determined whether this method would colonies identified were the same as those found in be truly reflective of the microbial population of the aerobic culture, no further susceptibility studies middle ear. were done. However if the colonies identified were 58
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Iq4LIPl:qut=S TABLE OF CONTENTS NEC
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HEAD AND NECK SURGERY - TO ADD OR N
Page 6 and 7:
PRESIDENT'S PAGE The years 1989-90
Page 8 and 9:
RIZAL MEDICAL CENTER DEPARTMENT OF
Page 10: muscles. Again it is likely possibl
Page 15 and 16: area measuring 4.8 x 3.7 cm extendi
Page 17 and 18: tend to recur locally, even after p
Page 20 and 21: UNIVERSITY OF THE PHILIPPINES PHILI
Page 22 and 23: The majority of patients with hyper
Page 24 and 25: mass wa uttrasonograImy. Neck explo
Page 26 and 27: Figure 2 : Parathyroid Adcnoma vs.
Page 28 and 29: E.wa_ileMassonLe_Maxilla "salt& pep
Page 30 and 31: of some clinical features as well a
Page 34 and 35: MCU HOSPITAL DEPARTMENT OF OTOLARYN
Page 37 and 38: JOSE REYES MEMORIAL MEDICAL CENTER
Page 39 and 40: nonetheless stated: "We have the im
Page 41 and 42: to the diagnostic know-how of the c
Page 43 and 44: PATIENTS & METHODS: These signs and
Page 45 and 46: Most patients in group 1 complained
Page 47 and 48: DISCUSSION: and septal deviation mi
Page 49 and 50: OSPITAL NG MAYNILA DEPARTMENT OF OT
Page 51 and 52: ..temporary relief. According to Ha
Page 53 and 54: CASE REPORT phonuclear cells. The r
Page 55 and 56: TITLE:Cleft Lip Surgeryfor Rural Fi
Page 57 and 58: After intubation and the endoctrach
Page 59: BIBLIOGRAPHY Converse, J.M., Recons
Page 63 and 64: Table 3. Distribution of Organism b
Page 65 and 66: J BIBLIOGRAPHY Y MACKOWIAK, P.A., J
Page 67 and 68: Figure 3. SENSITIVITY PATTERN OF Pr
Page 69 and 70: Figure 3. Percent SENSITIVITY PATTE
Page 71 and 72: loradatine 10 mg/tabletgiven once a
Page 73 and 74: 1. Severity of Symptoms 3. Comparis
Page 75 and 76: -J;r,ceiving 40 mg of loratadine da
Page 79 and 80: : ' : _ : ::::::: : : i : ::
Page 81 and 82: These patients are new patients see
Page 83 and 84: - Table Vl Baseline Signs and Sympt
Page 85 and 86: The following Table VII will show t
Page 87 and 88: • 14.Drowsiness: None 30 2 4 10 2
Page 89 and 90: Actifed's side effect of drowsiness
Page 91 and 92: " to be packed with one type of pac
Page 93 and 94: With regard to microbiology of nasa
Page 95 and 96: TABLE 6: MANNER OF CONTROL OF REBLE
Page 97 and 98: APPENDIX C MICROBIALGROWTH POTENTIA
Page 99 and 100: EAST AVENUE MEDICAL CENTER DEPARTME
Page 101 and 102: type (20%-30% of cases) varies from
Page 103 and 104: TABLE Ii HistologicalClassification
Page 105 and 106: THE LATERAL NASAL WALL IN FILIPINOS
Page 107 and 108: MIDDLE MEATUS: Diameter of ostium:
Page 109 and 110: .;4".,..:'.-" ............. '---.",
Page 111 and 112:
Figure 4. Variation in the location
Page 113 and 114:
This study presents variations with
Page 115:
ACKNOWLEDGMENT The authors would li
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