History-taking, Clinical Presentation, Diagnostic Evaluation, and Management of Chronic Suppurative Otitis Media (CSOM)

Chronic Suppurative Otitis Media (CSOM) is a persistent ear infection characterized by perforation of the tympanic membrane and chronic drainage from the middle ear. It is a significant global health concern, particularly in developing regions.

History-taking and Clinical Presentation

Patients with CSOM often present with:

• Persistent otorrhea (ear discharge) lasting more than six weeks.
• Hearing impairment, often conductive hearing loss.
• Recurrent episodes of ear pain (otalgia) and sometimes tinnitus.
• Possible complications such as dizziness or facial nerve involvement in severe cases.

Diagnostic Evaluation

Audiological Tests

Audiometry is performed to assess hearing loss severity, distinguishing conductive vs. sensorineural components.

Imaging Studies

CT and MRI scans are crucial for evaluating the extent of middle ear damage, identifying cholesteatoma, and ruling out complications such as intracranial spread.

Laboratory Assessments

Microbiological culture of ear discharge helps in identifying causative pathogens and guiding antibiotic therapy.

Management Strategies

Medical Management

Topical antibiotic ear drops (e.g., ciprofloxacin, ofloxacin) are commonly prescribed. Oral antibiotics may be required for systemic infections.

Surgical Interventions

Patients with persistent perforations or complications may require tympanoplasty or mastoidectomy.

Conclusion

Early diagnosis and appropriate management of CSOM are essential in preventing complications such as hearing loss and intracranial spread. Regular follow-up and patient education on ear hygiene are crucial aspects of long-term care.