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    Csom TT

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    The document discusses chronic suppurative otitis media (CSOM), including its classification, causes, symptoms, treatment options such as tympanoplasty surgery, and factors involved in tympanoplasty. CSOM is a chronic inflammatory process in the middle ear caused by bacterial infection that can cause permanent damage. Treatment aims to eliminate the disease, repair perforations, and control infections.

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    Csom TT

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    The document discusses chronic suppurative otitis media (CSOM), including its classification, causes, symptoms, treatment options such as tympanoplasty surgery, and factors involved in tympanoplasty. CSOM is a chronic inflammatory process in the middle ear caused by bacterial infection that can cause permanent damage. Treatment aims to eliminate the disease, repair perforations, and control infections.

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    The document discusses chronic suppurative otitis media (CSOM), including its classification, causes, symptoms, treatment options such as tympanoplasty surgery, and factors involved in tympanoplasty. CSOM is a chronic inflammatory process in the middle ear caused by bacterial infection that can cause permanent damage. Treatment aims to eliminate the disease, repair perforations, and control infections.

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    4 views24 pages

    Csom TT

    Uploaded by

    nahidanila439
    The document discusses chronic suppurative otitis media (CSOM), including its classification, causes, symptoms, treatment options such as tympanoplasty surgery, and factors involved in tympanoplasty. CSOM is a chronic inflammatory process in the middle ear caused by bacterial infection that can cause permanent damage. Treatment aims to eliminate the disease, repair perforations, and control infections.

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    of 24

    Today’s topics-

    Chronic suppurative Otitis Media


    (CSOM)
    Presented by –
    Dr. Md. Mazharul Islam
    Classification of Otitis Media
    • A. Acute otitis media / acute suppurative otitis media.
    • B. Chronic otitis media
    1. Chronic non-suppurative otitis media / Otitis media with
    effusion / glue ear.
    2. Chronic suppurative otitis media (CSOM) without
    cholesteatoma ( tubo-tympanic variety)
    3. Chronic suppurative otitis media (CSOM) with
    cholesteatoma ( Attico- Antral variety)
    4. Chronic Adhesive otitis media.
    5. Chronic specific otitis media, TB, Syphilis.
    CSOM- Chronic Suppurative Otitis Media

    Definition:

    It is the chronic inflammatory process by pyogenic


    organism involving the middle ear cleft producing
    irreversible pathological changes.
    (lasting for more than 3 month)
    • Type:
    • 1. Tubotympanic or Safe.
    • 2. Atticoantral or Unsafe.
    CSOM- Chronic Suppurative Otitis Media

    Aetiology:
    Sequlae of ASOM due to
    - Inadequate treatment of ASOM,
    -Virulence of organism,
    -Immunosupressed Patient,
    Repeated entry of infection through perforation in middle ear
    (dirty water)
    Repeated infection of RT reaching middle ear through E.
    tube
    Infection from sources; sinus ,nasophraynx Adenoid,Tonsil,
    Tuberculosis,
    Persistent traumatic rupture of TM,
    Grommet insertion.
    CSOM- Chronic Suppurative Otitis Media(cont.)
    Organisms:
    Pseudomonas aeruginosa.
    Proteus.
    E. coli.
    Staphylococcus.
    Streptococcus.
    Anaerobic:- Bacteroides fragalis.
    Anaerobic Streptococcus.
    CSOM- Chronic Suppurative Otitis Media(cont.)

    Pathology;

    The middle ear mucosa becomes oedematous and


    velvety; the pavement cells become secreting columner
    cells (goblet cells) due to metaplasia or extention of the
    mucosa from the E. tube.

    Same pathological changes also occur in the mastoid


    air cells.
    CSOM- Chronic Suppurative Otitis Media(cont.)

    Criteria of CSOM:
    •Loss of hearing,
    •Discharge from ear ,
    •Perforation of Tm.

    Loss of hearing:
    Mild conductive type of hearing loss- Small perforation
    Moderate conductive type of hearing loss – Largeperforation
    Sensory neural hearing loss - when Cochlea is affected in
    Long standing case.
    CSOM- Chronic Suppurative Otitis Media(cont.)

    Discharge from ear:


    Intermittent.
    Mucoid.
    Mucopurulent
    Usually no foul smell- but when infection by .
    pseudomonas or proteus may have bad smell.
    Profuse discharge when associated with URTI.
    CSOM- Chronic Suppurative Otitis Media(cont.)

    Perforation

    Central-
    Small.
    Large.
    Subtotal.
    CSOM- Chronic Suppurative Otitis Media(cont.)

    Investigations:
    •P T A
    •Pus for c/s
    •X-ray mastoid.
    •X-ray PNS
    •CT scan
    CSOM- Chronic Suppurative Otitis Media(cont.)

    Complications:
    Minor
    - mucosal polyp
    -Granulation tissue formation
    Major
    - Extra cranial.
    and
    -Intra cranial.
    CSOM- Chronic Suppurative Otitis Media(cont.)

    Aims of treatment:

    •To eliminate the disease

    •To repair the perforation.

    •To control the disease


    CSOM- Chronic Suppurative Otitis Media(cont.)

    Treatment:
    1. Aural toileting,
    2. Ear drops,
    3. Systemic antibiotics,
    4. Precautions,
    5. Treatment of contributory factors,
    6. Surgical treatment-tympanoplasty.
    CSOM- Chronic Suppurative Otitis Media(cont.)

    TYMPANOPLASTY
    Prerequisites of Tympanoplasty -

    1.Ear should be dry at least for 6 weeks.

    2. E. tube should be functioning .

    3. There must be enough cochlear reserve .

    4. There should be no contributory factors..


    CSOM- Chronic Suppurative Otitis Media(cont.)

    Advantages of Tympanoplasty
    •To make the ear dry by preventing further
    infection in the ear.
    •To improve hearing & to prevent further
    deteriorating of hearing.
    • To prevent complication.
    •For using hearing aid.
    •To enable recruitment in certain profession.
    CSOM- Chronic Suppurative Otitis Media(cont.)

    IS TYMPANOPLASTY DONE IN BANGLADESH?

    CAN IT BE DONE BY LOCAL ANESTHASIA?

    WHAT IS USED AS GRAFT AS MATERIAL?

    IS IT A COSTLY OPERATION?

    IS IT A RISKY OPERATION?

    DOES IT REQUIRE LONG HOSPITAL STAY?

    DOES THIS OPERATION HAVE MANY COMPLICATIONS?

    WHAT TYPE OF SURGERY IS IT?


    WHAT IS THE SUCCESS RATE OF THIS SURGERY?

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