Chronic Suppurative Otitis Media (CSOM): Symptoms & Treatment

CSOM: Chronic Suppurative Otitis Media

• Chronic: Disease lasts for more than 12 weeks.
• Suppurative: Pus
• Otitis media: Pus is in the middle ear.
• Long - standing infection in middle ear cleft lead to discharges & permanent perforation.

What is Permanent Perforation?

Perforation is permanent when the edges of the perforation are covered by stratified squamous epithelium and do not heal spontaneously.

Perforation

Tubotympanic Perforation

The disease begins at the eustachian tube and goes to the middle ear cavity.

1. Seen in younger age groups.  
2. Due to nasal or nasopharyngeal pathology
3. Antero inferior part of the middle ear gets affected.

Atticoantral Perforation

The disease begins in the attic and goes posteriorly into the mastoid air cells.

1. Seen in older people.
2. Occurs secondary to cholesteatoma
3. Posterosuperior part of the middle ear gets affected

Signs & Symptoms & Complications

Examination of CSOM

• Examine the ear : to check for permanent perforation.
• Evaluate Pathology: In the nose, nasopharynx or palate; Diagnostic nasal endoscopy or CT scan of the nose and paranasal sinuses can be done.
• High-resolution CT scan of the temporal bone: To evaluate the extent of erosion.
• Audiological Evaluation: To evaluate the degree of hearing loss.

Also read : Adenoid And Adenoidectomy 

Diagnostics

• Examination under Microscope - very important
• Audiogram: To assess the hearing loss degree
• Culture and sensitivity of the ear discharge.
• Mastoid X ray - sclerotic and extent of bone destruction.

Medical treatment 

• Aural toilet: Debris and aural polyp should be removed before treatment.
• Do not avulse an aural polyp.
• Ear drops: gentamicin.
• Systemic Antibiotics: Limited use only in acute exacerbation.
• Medication: to keep the ear dry.
• There are two types of treatment:
  • The disease will recur if the primary cause is not treated first.

FAQ’S

Q. How to prevent chronic otitis media?

Ans. It can be prevented by reducing exposure to secondhand smoking, managing allergies and other respiratory allergies.

Q. What are the complications of chronic otitis media ?

Ans. The complications such as hearing loss, speech delaying, and infection may spread to nearby structures and also spread to the brain.

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