Chronic Suppurative Otitis Media

CSOM : Chronic Suppurative Otitis Media

Word wise Meaning of CSOM:

Chronic- Long standing
Suppurative- Related with pus (containing or discharging pus)
Otitis- Inflammation of ear
Media- Middle ear

Definition

Chronic Suppurative Otitis Media or CSOM is a long standing infection of a part or whole of the middle ear cleft characterized by Ear discharge and a permanent Perforation. A perforation becomes permanent when it's edges are covered by squamous epithelium and it does not heal spontaneously. A permanent perforation can be likened to an epithelium-lined fistulous track.

Types of CSOM

Clinically, it can be divided into two types:-

Tubotympanic

Also called the safe or benign type.
It involves anteroinferior part of middle ear cleft ,i.e, eustachian tube and mesotympanum.
It is associated with central perforation.
There is no risk of serious complication.

Atticoantral

Also called unsafe or dangerous type.
It involves posterosuperior part of middle ear cleft, i.e, attic, antrum and mastoid.
It is associated with an attic or marginal perforation.
This disease is often associated with a bone-eroding process such as cholesteatoma, granulation or osteitis and risk of complication is very high.

Difference between Atticoantral and Tubotympanic CSOM

Features	Tubotympanic CSOM	Atticoantral CSOM

Discharge	Profuse Mucoid Odourless	Scanty Purulent Foul smelling
Perforation	Central	Attic/Marginal
Granulation	Uncommon	Common
Polyp	Pale	Red and fleshy
Cholesteatoma	Absent	Present
Complications Audiogram	Rare Mild to moderate conductive deafness	Common Conductive deafness or mixed deafness

Polyp in ear canal

This was general about Chronic Suppurative Otitis Media. There are its two types- Tubotympanic and Atticoantral CSOM.

Labels: ENT, Third year MBBS