Chronic Suppurative Otitis Media

Chronic suppurative otitis media (CSOM) is a widespread and persistent infectious disease affecting the middle ear and mastoid cavity, leading to significant morbidity. The condition often follows protracted acute otitis media (AOM) and is characterized by chronic purulent ear discharge through a perforated eardrum and varying degrees of hearing loss. Globally, CSOM affects between 65 and 330 million people and accounts for approximately 28,000 deaths annually. The prevalence varies significantly by region, influenced by factors such as hygiene, nutrition, healthcare access, and socioeconomic status. Pathophysiology involves persistent infection and inflammation, Eustachian tube dysfunction, and a disrupted balance of middle ear microbiota. Common pathogens include Staphylococcus aureus and Pseudomonas aeruginosa, with recent studies highlighting the presence of a diverse microbiome in both healthy and diseased ears. Clinical manifestations include ear discharge and hearing loss, with potential complications like mastoiditis and intracranial infections. Diagnosis relies on patient history, otoscopic examination, audiological tests, and imaging. Treatment focuses on controlling infection and preventing complications, using topical and systemic antibiotics, and surgery. Advancements in diagnostic tools and therapeutic strategies, including AI and novel non-surgical treatments, promise to improve CSOM management in the future.