Chronic Suppurative Otitis Media (CSOM): Diagnosis and Management

Introduction

Chronic Suppurative Otitis Media (CSOM) is a persistent ear infection that leads to chronic ear discharge and potential hearing loss. Effective history-taking, accurate clinical assessment, and a well-structured management plan are essential for treating CSOM.

History-Taking

Detailed patient history is crucial for CSOM diagnosis. Key points include:

• Duration and characteristics of ear discharge
• History of recurrent upper respiratory infections
• Previous ear surgeries or trauma
• Hearing impairment and tinnitus assessment

Clinical Presentation

Patients with CSOM commonly present with:

• Persistent otorrhea (ear discharge)
• Conductive hearing loss
• Perforated tympanic membrane
• Secondary infections or complications such as cholesteatoma

Diagnostic Evaluation

Diagnostic measures include:

• Otoscopy to assess tympanic membrane integrity
• Pneumatic otoscopy for middle ear function evaluation
• Audiometry for hearing assessment
• Imaging studies (CT/MRI) in suspected complications

Management Strategies

Medical Treatment

Medical management includes:

• Topical and systemic antibiotics for infection control
• Ear cleaning and aural toilet
• Anti-inflammatory medications for symptom relief

Surgical Options

For cases unresponsive to medical therapy:

• Tympanoplasty to repair perforations
• Mastoidectomy in advanced infections
• Reconstruction procedures for ossicular chain defects

Long-Term Care

Preventive care and patient education are essential:

• Avoid water exposure in the affected ear
• Routine follow-ups for disease progression monitoring
• Hearing rehabilitation strategies if necessary

Conclusion

CSOM requires a multidisciplinary approach for effective treatment and long-term care. Early intervention can prevent complications and improve patient outcomes.