Chronic suppurative otitis media (CSOM) is a persistent ear infection characterized by deafness, ear discharge, and perforation of the tympanic membrane. There are two main types: tubo tympanic CSOM, which is generally safe, and attico antral CSOM, which can be unsafe if it involves the entire middle ear cavity. Diagnosis involves examining the ear for signs of discharge, perforation and inflammation, and conducting audiological tests. Treatment consists of cleaning the ear, use of topical or systemic antibiotics, and sometimes surgery to repair the eardrum or address underlying nasal/sinus conditions contributing to the infection.

1. CHRONIC SUPPURATIVE
OTITIS MEDIA

2. ►Persistant disease, Severe
destruction
►It is characterized by:
Deafness
Ear discharge
T.m. perforation

3. TYPES OF C.S.O.M.
► Tubo tympanic s.o.m. Safe
► Attico antral Unsafe

4. ATTICO ANTRAL C.S.O.M.
► Cholesteatoma
Keratinizing Squamous Epithelium.
A small sac
May involve whole middle ear cleft

5. TUBO TYMPANIC C.S.O.M
► Deafness
► Discharge
► Central perforation

6. TUBO TYMPANIC C.S.O.M
► Patency of Eustachian
tube
► Nidus of infection in
U.R.T.I.
► Immune status of
patient
► Aerobic and Anaerobic

7. TYPES OF TUBO TYMPANIC
C.S.O.M.
► Active Tubo Tympanic C.S.O.M.
► Inactive Tubo Tympanic C.S.O.M.

8. DIAGNOSIS
TUBO TYMPANIC C.S.O.M.
► History
Long standing, unilateral, bilateral, painless
otorrhoea, deafness
► Discharge intermittent, mucoid,
mucopurulent,
► Non odorous
► Follow U.R.T.I. and entry of water.

9. Examination
► Main basis to assess activity , type , extent
► Inspection , otoscopy, e.u.m.
► Mucoid
► Perforation , central
► Pale mucosa
► Rarely polyp
► Pus for cs

10. Audiological assessment
► Voice test
► Tuning fork test Rinne, Webers , A.B.C.
► Pure tone audiogram

12. RADIOLOGICAL ASSESSMENT
► X-rays mastoid

14. RADIOLOGICAL ASSESSMENT
► CT-scan temporal bone

16. treatment
► Aural toilet
a. Cotton buds
b. Suction and cleaning
► Antibiotics
a. Topical antibiotics
b. Systemic antibiotics

17. Surgical treatment
► Precipitating disease
a. Adenoid
b. DNS
c. Nasal polyps
► Aural polypectomy
► Functional reconstruction tympanoplasty