Ninety percent patients presented with tubotympanic variety and 10% patients presented with attico-antral variety. Bacteriologically pure growth was found in 79.09% cases, mixed growth in 10.91% cases, no growth in 10% cases. [ncbi.nlm.nih.gov]

• Ear Discharge

  Age, sex, nasal allergy, and self-medication were not significant risk factors for non-healing ear discharge. Protracted non-healing ear discharge still remains a prominent feature of CSOM in our experience. [ncbi.nlm.nih.gov]

• Otalgia

  Some CSOM-causing microorganisms were-significantly more so than the others-characteristically associated with each of the following clinical features: quantity of pus drainage, mode of onset, otalgia, hearing loss, location of tympanic membrane perforation [ncbi.nlm.nih.gov]

  When cholesteatoma or other complications are suspected (as in a febrile patient or one with vertigo or otalgia), CT or MRI is done. [msdmanuals.com]

  The otorrhea should occur without otalgia or fever. Fever, vertigo and otalgia should prompt urgent referral to exclude intratemporal or intracranial complications. Hearing loss is common in the affected ear. [patient.info]

  In acute otitis media, otalgia is the most common complaint. Other common signs and symptoms include otorrhea, hearing loss, headache, fever, and irritability. [radiopaedia.org]

• Hearing Problem

  If your child isn't old enough to say "My ear hurts," here are a few things to look for Tugging at ears Crying more than usual Fluid draining from the ear Trouble sleeping Balance difficulties Hearing problems Your health care provider will diagnose an [icdlist.com]

  Screening for pre-school and school-age hearing problems: European Consensus Statement. Int J Pediatr Otorhinolaryngol 2012;76(1):120-121. [ http://dx.doi.org/10.1016/j.ijporl.2011.10.016 ] 11. Skarżyński H, Piotrowska A. [samj.org.za]

• Vertigo

  A positive history of vertigo was reported in 53.5% of the cases. Rotatory chair abnormalities were found in 70% of the cases, caloric hypofunction was found in 61.6%, and vestibular myogenic evoked potentials were abnormal in 25%. [ncbi.nlm.nih.gov]

  Vertigo Continuous or intermittent episodes of vertigo may occur, since the organ of hearing and balance are one anatomically connected organ. [entspeciality.com]

  The principal reasons for failure of discharge on the day of surgery were asthenia (6 cases), vertigo and asthenia (4 cases), undetermined (2 cases). [audiologyresearch.org]

  Features indicating complications of CSOM Pain Vertigo Persistent headache Facial weakness A listless child refusing to take feeds and easily going to sleep Fever, nausea and vomiting Irritability and neck rigidity Diplopia Ataxia Abscess around ear 18 [slideshare.net]

• Dizziness

  Typically, associated with conductive hearing loss, untreated CSOM can result in serious complications such as mastoiditis, facial nerve paralysis, cholesteatoma formation, dizziness, and intracranial infections. [neurotucson.com]

  If there is already toxic inner ear damage, with or without tinnitus or dizziness, the procedure should take place regardless. [ims.uniklinik-freiburg.de]

  2 Clinical picture Patients with CSOM may consult a doctor with one of the following: 2 • a newly discharging untreated ear • a persistently discharging initially treated ear • a recurrently discharging ear • a discharging ear with headache, fever, dizziness [cmej.org.za]

  Suspected ototoxicity One study (Sanchez Gonzales 2001; 30 participants) reported on dizziness or vertigo, but no details were provided regarding the method used to assess this. [cochranelibrary.com]

• Confusion

  CASE REPORT A 58-year-old male African American presented with headaches and confusion. Magnetic resonance imaging (MRI) of the head showed petrous apicitis with mastoiditis and abscess formation in the cerebellomedullary cistern (cisterna magna). [ncbi.nlm.nih.gov]

  Warning signs of chronic otitis media include:5 Persistent blockage of fullness of the ear Hearing loss Chronic ear drainage Development of balance problems Facial weakness Persistent deep ear pain or headache Fever Confusion or sleepiness Drainage or [thermofisher.com]

[Figure 2] CSOM was considered to be the cause of the cortical venous thrombosis as the workup to rule out non-infective causes was negative. [jacmjournal.org]

[…] lateralization can also cause a conductive loss Sensorineural hearing loss is rarely seen but is considered a serious complication Vertigo can occur during any middle ear procedure and is usually self-limiting; however, if it is severe or persistent, further workup [emedicine.medscape.com]

• Pseudomonas

  […] agent is Pseudomonas aeruginosa. [ncbi.nlm.nih.gov]

• Polyps

  Granulation/polyp tissue was as important as cholesteatoma in the erosion of the facial canal and sigmoid sinus plate. [ncbi.nlm.nih.gov]

  Antrochoanal Polyp 2 2.0 3 3.0 4. Antrochoanal Polyp + DNS 0 0.0 1 1.0 5. Adenoid 1 1.0 1 1.0 6. DNS 9 9.0 16 16.0 7. Ethmoidal polyp 4 4.0 3 3.0 8. Maxillary. Polyp 1 1.0 0 0.0 9. Maxillary sinusitis 9 9.0 9 9.0 10. [jemds.com]

  Perforation in Tubotympanic CSOM Chronic Suppurative Otitis Media Middle ear mucosa- Pale pink and moist on normal but when inflamed, it looks red, oedematous and swollen and occasionally with polyps. [medicforyou.in]

Clinical presentation, imaging studies, operative findings, surgical treatment, and postoperative results were evaluated. [ncbi.nlm.nih.gov]

Referral for specialist treatment is indicated in cases of suspected complications, cases not responsive to treatment or cases of hearing loss (Fig. 1). [cmej.org.za]

The presence of a hemorrhagic lesion on computed tomographic scan and deep coma at presentation indicate poor prognosis. [ncbi.nlm.nih.gov]

The presence of a hemorrhagic lesion on computed tomographic scan and deep coma at presentation indicate poor prognosis. Footnotes [stroke.ahajournals.org]

Intratemporal complications include: Petrositis Facial paralysis [ 17 ] Labyrinthitis Intracranial complications include: Lateral sinus thrombophlebitis Meningitis Intracranial abscess Sequelae include: Hearing loss Tympanosclerosis Prognosis [ 2 ] Prognosis [patient.info]

Exact prevalence in different age groups is unknown; however, some studies estimate the yearly incidence of CSOM to be 39 cases per 100,000 in children and adolescents aged 15 years and younger. [14] Prognosis Patients with CSOM have a good prognosis [emedicine.medscape.com]

Prognosis The natural history of chronic suppurative otitis media is poorly understood. [aafp.org]

Preauricular incision, disturbance of venous and lymphatic drainage, and preseptal cellulitis were the possible etiological factors. [ncbi.nlm.nih.gov]

Etiology The Etiology of Tubotympanic CSOM is as follows: Sequela of Acute Otits Media following exanthematous (eruptive) fever and leaving behind a large central perforation which becomes permanent and permits repeated infections from external ear. [medicforyou.in]

Abstract To evaluate the shift in epidemiological and complication profiles of chronic suppurative otitis media (CSOM) over two decades in a resource-limited economy. [ncbi.nlm.nih.gov]

Clinico epidemiological study of complicated and uncomplicated chronic suppurative otitis media. J Laryngol Otol. 2008;122:442-6. Datta PG, Newton VE, Amin MN, Chowdhury RKD. [ijorl.com]

The pathophysiology of the concurrent complications is discussed. [ncbi.nlm.nih.gov]

Pathophysiology CSOM is initiated by an episode of acute infection. The pathophysiology of CSOM begins with irritation and subsequent inflammation of the middle ear mucosa. The inflammatory response creates mucosal edema. [emedicine.medscape.com]

Its pathophysiology begins with irritation and subsequent inflammation of the middle ear mucosa. The most important pathological factors in CSOM are dysfunction of the Eustachian tube and bacterial infection. [jemds.com]

(B) Pathophysiology (i) Progressive inflammation & hyperaemic thickening of mucoperiostium Þ periostitis. (ii)Obstruct’n of aditus ad antrum ("bottleneck") B/W mastoid & middle ear. (iii) Accumulation of serous then purulent exudates in the cells. [ent.com.au]

The patients suffering from ear perforation or having a hole in eardrum require preventing entry of water in the ear. [ncbi.nlm.nih.gov]

Wearing a hearing aid can exacerbate the problem by preventing air circulating through the ear canal, and the ear from drying out. [iwanttohear.com]

Epidemiology and pathogenesis of chronic suppurative otitis media: implications for prevention and treatment. Int J Pediatr Otorhinolaryngol 1998;42: 207-223. 1. Bluestone CD. [cmej.org.za]