Current Concepts in the Pathogenesis and Treatment of

Chronic Suppurative Otitis Media

BY :
OKKIS RAZUANSYAH SIREGAR
71160891435
MENTOR :
dr. Fauziah Henny, Sp. THT-KL
Anatomy of The Ear

Outer
Ear

Middle
Ear

Inner Ear
Anatomy of Tympanic Membrane
Abstract
Otitis media (OM) is an inflammation of the middle ear
associated with infection.
Acute OM (AOM) may develop into chronic suppurative
OM (CSOM) associated with ear drum perforation and
purulent.
Incidence
CSOM usually develops in the first years of life but can per-sist during
adulthood. The disease affects 65330 million people worldwide, mainly in
developing countries. It has been estimated that there are 31 million new
cases of CSOM per year, with 22.6 % in children less than 5 years old.

A B

Otoscopic examination of the ear

Types

Tubotympanic
It involves anteroinferior part
of middle ear cleft (eustachian
tube, mesotympanum) and is
associated with a central
perforation
Safe/benign type
No risk of serious
complications
Atticoantral
It involves posterosuperior part of the
cleft (attic ,antrum, mastoid)
Associated with an attic or marginal
perforation
It is often associated with bone eroding
process such as
cholesteatoma,granulations or osteitis
Risk of complications is high
Unsafe/dangerous type
Microbiology
Pathogenesis
Treatment

Ototopical Systemic
Antibiotics Antibiotics

Aural
Surgery
toilet
Treatment
Ototopical Antibiotics
Quinolone topikal

Aminoglikosida topikal

Alumunium asetat (larutan Burrow)

Asam asetat

Povidone-iodine
Systemic Antibiotics
Aminoglikosida

Pipercillin-tazobactam

Ceftazidime

Quinolone

Penicillin
Surgery
Tympanomastoidectomy is indicated in the case of CSOM where there
are complications, some of which are potentially life-threatening, such
as significant hearing loss, facial nerve paralysis, subperiosteal abscess,
petrositis, venous dural venous thrombosis, meningitis, cerebral abscess
and labyrinth fistula, and cholesteatoma.
Tympanoplasty can be performed anywhere from 6 to 12 months after
resolution of the infection. Tympanoplasty is indicated to improve
hearing and to help prevent recurrence of infection .
Conclusions
CSOM is the most common chronic infectious disease
worldwide. The factors underlying the pathogenesis of
CSOM are still poorly understood. There is an urgent
need to focus research studies in the area of CSOM,
which will open up avenues to design novel therapeutic
studies against CSOM and hence prevent hearing loss.
THANK YOU