Chronic Otitis Media

Question 1

How can it be divided?

Answer 1

Mucosal disease - active or inactive

Squamous disease - active or inactive

Question 2

Active squamous disease is also known as…

Answer 2

Cholesteatoma

Question 3

What is inactive squamous disease?

Answer 3

A retraction pocket which may develop into active disease - cholesteatoma

Question 4

What is active mucosal disease?

Answer 4

Where there is chronic discharge from the middle ear through a tympanic membrane perforation

Question 5

What is inactive mucosal disease?

Answer 5

When there is a tympanic membrane perforation but no active infection/discharge

Question 6

Mucosal COM is thought to develop from…

Answer 6

An episode of AOM where after rupturing of the membrane there is failure to heal

Question 7

Active squamous COM is thought to develop when…

Answer 7

Keratinised squamous cells are introduced into the middle ear from a retraction pocket or a perforation

Question 8

What is active COM associated with?

Answer 8

Chronic ear discharge and often conductive hearing loss

Can also be associated with spread of the disease - within temporal bone and intracranially

Question 9

How is a chronically discharging ear managed?

Answer 9

Often not known if cholesteatoma present, so treat medically first and then if this fails surgery should be carried out - cholesteatoma may or may not be discovered
Medical = topical antibiotics drops and aural toileting
In surgery with no cholesteatoma- repair perforation and ensure good ventilation of middle ear