Chronic suppurative otitis media

• Chronic suppurative otitis media
  • Persistent drainage from middle ear through perforated tympanic membrane lasting > 6 weeks
    • Perforated tympanic membrane usually heals within weeks
    • No healing -> sign of chronic inflammation
  • Older children
  • Bacteria enter through perforated TM
  • Clinical features
    • 3 yes 1 no
    • Yes: Perforation of TM
    • Yes: Ear discharge
    • Yes: Conductive hearing loss
    • No: No pain
  • Two types
    • Mesotympanic
      • Central perforation
      • Treatment: tympanoplasty
    • With cholesteatoma
      • Cholesteatoma: keratinizing squamous epithelium found in bony spaces, and the bone is destroyed by inflammatory osteoclastic process
        • In TM, auditory canal or mastoid
      • Can become infected
      • Marginal perforation
      • Brown irregular mass
      • Imaging to assess bone destruction
      • Treatment: surgery

‎