E.N.T-CSOM  


CHRONIC SUPPURATIVE OTITIS MEDIA

It is a long standing infection of a part or

whole of the middle ear cleft charactrised

by ear discharge and a perforation.

Epidemiology

Incidence of CSOM is higher in developing

countries because of low socio-economic

standards,poor nutrition and lack of

health education.

It affects both sexes and all age groups.


Types of CSOM

It is divided into two types

1)Tybotympanic

2)Atticoantral



1)Tybotympanic

It is also called safe or benign type and

it involves anterioinferior part of middle

ear cleft and is associated with a central

perforation.

Aetiology

It is common in childhood

It is the sequela of acute otitis media

usuallyfollowing exanthematous fever

Ascending infection via the eustachian tube.

Pathology

1)Perforation of pars tensa

2)Edematous of middle ear mucosa

3)Polyp in external canal

4)Some degree of nicrosis in ossicular chain

5)Tympanosclerosis

6)Fibrosis and adhesions

Bacteriology

Common aerobic organims-

1)PS aeruginosa

2)Proteus

3)Esch. coli

4)staph. aureus

common anaerobes are

1)Bacteroides fragilis

2)anaerobic sreptococci

Clinical Features

1)Ear discharge

2)Hearing loss

3)Perforation of tympanic membrane

4)Oedematous and swollen of middle ear

Investigation

1)Examination under microscope

2)Audiogram

3)Culture and sensitivityof ear discharge

4)Mastiod x-rays

Treatment

1)aural tiolet

2)ear drops containing neomycin,

polymyxin,chloromycetin.

3)systemic antibiotics

4)precausions

5)treatment of contributory causes

6)surgical treatment

7)reconstrutive surgery

What next?

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