Chronic Suppurative Otitis Media
What is it?
Chronic Suppurative Otitis Media (CSOM) refers to a perforated tympanic membrane and either constant or intermittent drainage from the ear.
Symptoms of CSOM include discharge from the ear and, oftentimes, hearing loss.
CSOM is usually the result of a chronic tympanic membrane perforation and infection in the middle ear. The infection usually extends to the mastoid bone behind the ear. It is aggravated by water entering the ear canal and getting through the tympanic membrane perforation into the middle ear. Upper respiratory tract infections (e.g. colds or the flu) can also aggravate the infection. If left untreated, CSOM can result in potentially devastating consequences such as permanent hearing loss, facial nerve paralysis, and infections of the spinal fluid (meningitis) or brain abscess.
An examination of the ear using an otoscope and diagnostic microscope is used to evaluate the condition. Audiograms are used to gauge the extent of hearing loss. A CAT scan may also be prescribed to determine the extent of disease.
A combination of therapies may be used to treat CSOM. Antibiotics alone are usually ineffective as they do not address the tympanic membrane perforation and cannot often eradicate disease within the bone-enclosed mastoid. If the patient’s medical condition permits, surgery is often recommended in conjunction with antibiotic therapy. Specifically, a tympanomastoidectomy procedure in which the mastoid is opened and cleaned and the eardrum perforation is repaired is usually indicated. Depending on the extent of disease, the surgery may be staged, meaning a second surgery may be necessary to reconstruct the hearing mechanism after the infection has been addressed through the first surgery. The two procedures are usually spaced by approximately six months.