Chronic Suppurative Otitis Media
Acute otitis media can lead to the infection rupturing the eardrum, leaving a perforation (Figure 9.1). This usually heals, but may persist and cause recurrent episodes of discharge (chronic suppurative otitis media, CSOM).
In addition to discharge, the patient may complain of increasing deafness. Persistent infections can lead to spread of infection beyond the ear, resulting in intracranial or extracranial complications (see Chapter 8).
Presentation
A perforation of the eardrum may cause little or no trouble. The ear is liable to discharge when the patient has a respiratory tract infection or if the ear gets wet (e.g. after swimming or hair washing). Some degree of hearing loss is inevitable but it may be slight. If in addition to the perforation the infection has eroded the ossicles, deafness can be more severe. The cochlea is usually not involved so hearing loss is conductive and incomplete.
Treatment of a Perforated Eardrum
Management options include the following:
- Conservative management.
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