Chronic Suppurative Otitis Media

Question 1

What is the causes of mucosal CSOM?

Answer 1

1. Permanent central perforation
   - trauma/ASOM > 3 months -> epithelialization of margins of TM -> permanent TM perforation
2. Infection -> through ET -> inflammation of middle ear mucosa

Question 2

What is the C/F of mucosal CSOM?

Answer 2

1. Ear discharge + URTI
   - mucoid, profuse, non foul smelling, painless
2. Conductive hearing loss

Question 3

What is the management for active mucosal CSOM?

Answer 3

1. Symptomatic = aural toileting
2. Medical = antibiotics (ear drops & oral)

Question 4

What is the management for inactive mucosal CSOM?

Answer 4

After 6 weeks of dry ear
- involves TM only = myringoplasty
- involves TM & ossicles = tympanoplasty (myringoplasty & ossiculoplasty)

Question 5

What is the most common type of ossicle to undergo necrosis?

Answer 5

Long/lenticular process of incus due to decrease blood supply

Question 6

What are the pre-operative evaluation?

Answer 6

1. Examination under microscopy
2. Oto endoscopy (5 cm)
3. Pure tone audiometry

Question 7

What is patch test?

Answer 7

It’s an OPD procedure where the TM perforation is closed with a patch
If hearing loss improves -> TM perforation only
If hearing loss increases -> ossicular discontinuity