Causes and risk factors
Chronic suppurative otitis media occurs as a result of repeated episodes of acute otitis media. Living in unhygienic conditions or excessively crowded areas is associated with a higher risk of developing CSOM. People with craniofacial anomalies such as cleft palate or choanal atresia are at a higher risk of developing CSOM.
Clinical presentation
Chronic otitis media presents with recurrent discharge from the ear from a perforated tympanic membrane. The discharge is usually purulent or fetid. However, there is no earache or fever. There is a varying degree of hearing loss in the affected ear. The tympanic membrane appears edematous.
Investigations
The doctor carries out an ear examination which reveals the following:
- Swollen external auditory canal,
- Presence of granulation tissue in the ear canal,
- Presence of ear discharge.
An audiogram is performed to test the hearing.
A CT or MRI scan may be performed to look for the presence of cholesteatoma or other complications.
Treatment
Aural cleaning is carried out by the doctor. Topical antibiotics and topical steroids are prescribed to fight the infection and inflammation.
Surgery – Surgical intervention may be necessary depending upon the severity of CSOM. Myringoplasty or tympanoplasty surgery is performed to repair the eardrum.
Complications
Formation of cholesteatoma is a common complication. Other complications include erosion of the ossicles, subperiosteal abscess, tympanosclerosis, labyrinthitis, brain abscess, and hearing impairment.
When to contact a doctor
Contact a doctor as soon as you develop discharge from the ear.
Prevention
Keeping the ear dry and maintaining good hygienic practices help to prevent the incidence of CSOM.
Systems involved
Otology
Organs involved
Ear
WHO statistics
According to the 2004 WHO report on CSOM, the prevalence of CSOM ranges from less than 1% in developed countries like UK to as high as 30% to 46% in certain regions such as Alaska.
