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Summary Diseases of Ear, Nose & Throat and Head & Neck Surgery - E-Book - MBBS01
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Summary notes upon Chronic Suppurative Otitis Media [CSOM]. One of the common disease which people suffer from
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What is Chronic Supparative Otitis Media(CSOM)?
Chronic Suppurative Otitis Media:
Understanding the Condition
Chronic Suppurative Otitis Media, or CSOM, is a condition
characterized by a perforated tympanic membrane with
persistent drainage from the middle ear lasting more than 12
weeks. It is initiated by episodes of acute infections and begins
with irritation and subsequent inflammation of the middle ear
mucosa.
The inflammatory response creates mucosal edema and
increases middle ear discharge, eventually leading to tympanic
membrane perforation. A perforation becomes permanent when
its edges are covered by squamous epithelium and it does not
heal spontaneously. Clinically, CSOM is divided into two types:
Tubotympanic (safe or benign type): Involves the anteinferior
part of middle ear cleft and is associated with a central
perforation. There is little risk of serious complications.
Atticoantral (unsafe or dangerous type): Involves
posterosuperior part of the cleft, i.e. attic, antrum, and
mastoid, and is associated with an attic or marginal
perforation. The disease is often associated with a bone-
eroding process, and the risk of complications is high.
Investigations
CSOM can be investigated using the following methods:
1. Examination under microscope
2. Audiogram: It gives an assessment of the degree of hearing loss
and its type.
3. Culture and sensitivity of ear discharge: It helps in selecting
proper antibiotic ear drops.
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