To evaluate the shift in epidemiological and complication profiles of chronic suppurative otitis media (CSOM) over two decades in a resource-limited economy. A retrospective analysis of the prevalence of CSOM and its complications in tertiary health institution a over a period of 2 years were compared between 203 cases seen in 2009 and December 2010 (present era); and 343 cases seen in 1990 and 1991 (previous era). Data were collected on the demographic characteristics of the patients, age of onset of otorrhoea, the disease type, laterality and complications of CSOM. The prevalence of CSOM significantly reduced from 9 % in the previous era to 5.1 % in the present era (P < 0.0001). The mean age of the recent group was 27.6 ± 19.3 years, and was 21.6 ± 18.2 years in the previous group. (P = 0.009). Although both group had peak age prevalence at 11-20 years, recent group saw more significant adult population >20 years of age (P ≤ 0.001). More significant cases of cholesteatoma were documented in the recent group (3.4 %) than previous era (0.9 %) (P = 0.02). Although no significant change was noted regarding the rates of complication of CSOM in the two eras (P = 0.18), there was a notable shift toward predominant extracranial pattern of complication in the recent group (P = 0.04). The prevalence of CSOM has shown a significant reduction after two decades and it appears that there has been a shift in the epidemiology of CSOM towards a predominantly adult population in the recent years. Despite an overall reduction in the incidence of intracranial complications of CSOM in our series, its complication rates have not changed remarkably after 20 years.

Objectives To evaluate the quality of life of patients with ongoing tinnitus. Study Design This was a cross-sectional study of patients with ongoing tinnitus. Setting The study was carried out in a tertiary hospital in southeastern Nigeria. Subjects and Methods Subjects are adults who presented to the otorhinolaryngology clinic with tinnitus as their primary complaint. Pure-tone audiometry, tinnitus pitch, and loudness matching were done. The Tinnitus Handicap Inventory (THI) questionnaire was used in assessing their quality of life. Results There were 63 participants within the age range of 16 to 74 years; 20 (31.7%) were male and 43 (68.3%) were female. The mean duration of tinnitus was 26.7 ± 38.1 months. Nineteen (30.2%) participants had bilateral tinnitus while 44 (69.8%) had unilateral tinnitus. The mean THI score was 36.6 ± 19.7. The most reported handicap was anxiety and difficulty with concentration followed by depression and irritability. There was no correlation between the disability shown by the THI score and the age, sex, duration of the tinnitus, the tinnitus pitch, tinnitus loudness, or the laterality of the tinnitus. There was a significant positive correlation between the grade of hearing loss and the level of disability reported in the THI ( P = .01). Conclusion Tinnitus sufferers appear to have poorer quality of life compared with nonsufferers. This quality-of-life affectation is likely to be worse in those with disabling hearing loss but does not appear to be related to their age, sex, symptom duration, or the loudness and pitch of their tinnitus.

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Although the mortalities from malignant otitis externa (MOE) have greatly reduced, it is still a potentially fatal clinical condition. This study was undertaken to review the treatment outcomes and prognostic factors in MOE and to compare the behavioral pattern of cases caused by pseudomonas and nonpseudomonas organisms. A retrospective chart review of patients diagnosed with MOE in a tertiary institution over a 13 year period was conducted. Treatment outcome was divided into survival and mortalities groups. Demographic and disease factors were analyzed regarding mortalities using univariate and multivariate analysis. Seventeen of 22 cases were analysed. Nine (53%) were diabetic while 5 were HIV positive. After average of 7 weeks of antibiotic therapy ± surgical debridement, the disease resolved in 59%. Mortality was 41%. Diagnostic delay, poor blood sugar control, and extensive disease were found to predict mortality (P = 0.051, 0.048, and 0.006 respectively). Age, sex, causative organism, HIV infection, facial nerve and other cranial involvement did not significantly predict mortality. Pseudomonas aeruginosa was isolated in 11 patients. The rest had atypical organisms, Staphylococcus aureus and Proteus spp. There was no significant difference in the disease extension, mortality, duration of treatment and facial nerve involvement between pseudomonas and nonpseudomonas groups. However the pseudomonas group were predominantly diabetic (p = 0.03). It is concluded that malignant otitis externa still has a significant mortality despite aggressive therapy. Extensive temporal bone/intracranial disease, poor blood sugar control, and diagnostic delay portend a poorer prognosis. S. aureus is an increasingly important causative organism in MOE especially in nondiabetic patients.