| ID | 285 |
|---|---|
| Name | SAFE VARIETY OF CSOMW |
| Cause | CSOM can be caused by bacterial and/or fungal infection (often polymicrobial), including Pseudomonas aeruginosa (most common), Staphylococcus aureus, Proteus spp., Aspergillus spp., Candida albicans. |
| Signs Symptoms | A common presenting symptom is hearing loss in the affected ear. Reports of fever, vertigo, and pain should raise concern about intratemporal or intracranial complications. A history of persistent CSOM after appropriate medical treatment should alert the physician to consider cholesteatoma |
| Diagnosis | |
| Investigations | |
| Management | Management: 1. Aural toilet- is most important & is done by-a. dry moping, b. syringing the ear & subsequent moping, c. suction clearance. 2. After aural toilet local disinfection is done by-i. Cortisone with neomycin ear drop, ii. In some cases of pseudomonas infection gentamicin drop is used. 3. If discharge persists- C/S is done & antibiotic is changed accordingly. 4. Source of infection- infection of nasopharynx, sinus, adenoid, tonsil is considered & measures are taken accordingly. 5. Precautions- a. avoid entry of water in the ear. b. avoid swimming & diving. c. ear is plugged with cotton wool impregnated with vaselin when hair is washed, d. avoid cleaning of ear discharge with dirty cotton or linen. 6. General nutrition- good foods, vitamins are given. 7. If above treatment fails then please consult with an specialist. 8. Trichlor acetic acid or myringoplasty for repair of perforation. |
| Introduction | |
| History | |
| Etiology | see under causes |
| Clinical Features | Stages- active stage, quiescent stage, inactive stage. 1. Recurrent otorrhoea- discharge is watery mucoid or mucopurulent & non foetid. In between infection the ear is dry. 2. Deafness- pain may be present due to secondary infection. Progressive and conductive deafness. 3. Perforation of the tympanic membrane is central. |
| Preventions | ympanoplasty, a surgery that seals the perforation, prevents the translocation of bacteria from the external ear canal into the middle ear; |
| Treatment | Systemic antibiotics are a commonly used treatment option for CSOM, which act to kill or inhibit the growth of micro‐organisms that may be responsible for the infection. Antibiotics can be used alone or in addition to other treatments for CSOM. |
| Complications | Petrositis. Petrositis occurs when the infection extends beyond the confines of the middle ear and mastoid into the petrous apex. ... Facial paralysis. ... Labyrinthitis. ... Lateral sinus thrombophlebitis. ... Meningitis. ... Intracranial abscesses. ... Middle ear complications. ... Other. |
| Prognosis | |
| Types | |
| Classification | |
| Observation | |
| Pathology |
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