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]

• Insect Bite

  It may be of odontogenic or traumatic origin or may arise from insect bites, burns or surgical infections. [ncbi.nlm.nih.gov]

• Periorbital Edema

  In 24 cases (26.09%), the patients complained of mild periorbital edema and the condition was classified as grade 2. Four cases (4.35%) were classified as grade 3 because of severe edema with erythema on eyelids. [ncbi.nlm.nih.gov]

• Periorbital Ecchymosis

  One case (1.09%) was classified as grade 4 because of periorbital ecchymosis in addition to edema. The clinical features and the possible etiology were analyzed and are discussed. [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]

  Introduction CSOM is a long-standing infection of a part or whole of the middle ear cleft characterized by ear discharge and a permanent perforation. 3. [slideshare.net]

• 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]

• Neglect

  BACKGROUND: In developing countries, ear infections and deafness are usually neglected conditions due to insufficient funds, work force, facilities, and knowledge. [ncbi.nlm.nih.gov]

  These clinical obstacles, along with the high prevalence in developing countries, have led WHO to recognize CSOM in an expanded list of neglected conditions beyond its group of 17 neglected tropical diseases (NTDs) [ 8 ]. [journals.plos.org]

  Poverty is a major risk factor in developing countries and certain neglected population (8). Swimming in polluted water is an important cause of suppurative otitis media in our children. [arquivosdeorl.org.br]

  The health focus of these countries then becomes those prescribed by these donor agencies with neglect of important disease conditions like CSOM [ 11 ]. Tubotympanic disease was more prevalent than attico-antral disease in our study. [panafrican-med-journal.com]

• 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]

• Communicating Hydrocephalus

  Computed tomographic scan of the brain revealed left mastoiditis with cholesteatoma and moderate communicating hydrocephalus. The patient was subjected to left radical mastoidectomy, and an attico-antral cholesteatoma was removed. [ncbi.nlm.nih.gov]

[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]

• Calcium Increased

  […] location (urban area) (OR = 0.27; 95% CI: 0.13-0.56), serum calcium increasing (OR = 0.09; 95% CI: 0.01-0.71) were prime risk factors for CSOM. [ncbi.nlm.nih.gov]

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]

Objective: The present study was aimed to speculate the etiological fungal flora responsible for the cases of CSOM among patients who attended the Ear, Nose, and Throat Department of our hospital a tertiary care center in Uttarakhand. [atmph.org]

However, poorly treated AOM was found to be the commonest etiological factor. The provision of adequate health facilities and eradication of poverty possibly will reduce the prevalence of pediatric CSOM in our environment. [sciencedomain.org]

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]

A more recent study investigated the efficacy of pneumococcal vaccination in Aboriginal children in Australia for the prevention of otitis media [ 24 ]. [journals.plos.org]

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