Figure 1: Audit Cycle
Summary of Data from
Initial Audit Cycle
During the first cycle of the audit, data was collected from the
patients that presented to the ENT OPD in Dec 2021. Only the patients
that had an exclusive ear problem were chosen.
A total of 354 patients were involved. It was found that 59.3% of these
patients were males and 40.7% were females. The most common and
predominant presenting ear complaints were ear discharge (27.1%), pain
in the ear (20.3%), Ear fullness (17.6%), ear itch (15.3%), and
hearing loss (13.6%). In addition, other less common complaints
included tinnitus (2.8%), vertigo (1.7%), foreign body impaction in
the ear (1.2%), and bleeding (0.6%) from the ear.
On establishing the diagnosis, it was found that wax Impaction was the
most common ear problem encountered (26.6%), followed by CSOM (24.9%),
otomycosis (11.9 %), Hearing loss (7.9%), and then Acute Otitis Media,
Otitis Externa and Eustachian tube dysfunction (each 5.6%).
The details of the established diagnosis are in Table 1.
Of all these patients that reported an ear problem, 52.5% (186 out of
354) needed ear suctioning. And of those that needed ear suctioning,
44.1% had wax impaction, 35.5% had CSOM that required suction for
clearing pus from the canal, 12.9% had otomycosis requiring suctioning
of the fungal debris and another 4.3% had Acute otitis media who
required discharge suctioning. Suctioning was also required for a few
cases with ear bleeds and foreign bodies in the ear.
So, it was found that more than half of the patients with ear problems
require suction; wax, discharge from the ear, and fungal debris in the
ear are the 3 most common reasons. It was recommended that since a
significant percentage of 52.5 is requiring ear suction, it should be
started in the OPD department so that the unnecessary referral to the
ENT MOT would be reduced.