Chronic otitis media

Chronic otitis media (COM) is a long-lasting inflammation or infection of the middle ear. This condition typically persists for an extended period and may recur despite treatment. There are two main types of chronic otitis media: chronic suppurative otitis media (CSOM) and chronic nonsuppurative otitis media.

  1. Chronic Suppurative Otitis Media (CSOM):
  • Definition: CSOM is characterized by persistent inflammation of the middle ear with the presence of ear discharge (otorrhea) through a perforated tympanic membrane.
  • Causes: It often results from recurrent acute otitis media or persistent ear infections. Prolonged inflammation can lead to tympanic membrane perforation.
  • Symptoms: Symptoms may include ear discharge, hearing loss, ear pain, and a feeling of fullness in the ear.
  • Complications: If left untreated, CSOM can lead to complications such as cholesteatoma (a cyst-like growth in the middle ear), hearing loss, and, in severe cases, involvement of surrounding structures.
  1. Chronic Nonsuppurative Otitis Media:
  • Definition: This type involves chronic inflammation without active bacterial infection or ear discharge.
  • Causes: Factors contributing to chronic nonsuppurative otitis media may include eustachian tube dysfunction, allergies, or autoimmune conditions.
  • Symptoms: Patients may experience hearing loss, tinnitus (ringing in the ears), and a sensation of fullness or pressure in the ear.
  • Treatment: Management involves addressing underlying causes, such as allergy management, and may include hearing aids if hearing loss is significant.

Common Features of Chronic Otitis Media (Both Types):

  • Hearing Loss: Persistent inflammation and damage to the middle ear structures can lead to conductive hearing loss.
  • Tympanic Membrane Changes: The tympanic membrane (eardrum) may show structural changes, perforation, or retraction pockets.
  • Recurrent Episodes: While chronic otitis media implies a prolonged course, it may involve recurrent exacerbations.

Diagnosis and Treatment:

  • Diagnosis: Diagnosis involves a thorough examination of the ear by an otolaryngologist (ear, nose, and throat specialist), often aided by imaging studies (e.g., CT scan).
  • Treatment: Treatment depends on the specific type and cause. It may involve antibiotics, ear cleaning, and, in some cases, surgical interventions such as tympanoplasty (reconstruction of the eardrum) or mastoidectomy (removal of infected mastoid air cells).

Chronic otitis media requires professional evaluation and management. Timely intervention is crucial to prevent complications and improve outcomes. Individuals experiencing ear pain, discharge, or hearing difficulties should seek medical attention for proper diagnosis and treatment.