CHRONIC SUPPURATIVE OTITIS MEDIA

It is a chronic infection of middle ear dert.

Types
Chronic Suppurative Chronic non Chronic specific otitis
otitis media ( CSOM) suppurative otitis media, tuberculous or
media syphilitic otitis media

Chronic Suppurative Otitis Media : (CSOM)

It is a very common condition in our country.
Types of CSOM
Benign / Tubotympanic central Dangerous / Atsico- antral attic or
perforation ear drum disease limited marginal perforation.
to tympnum and the eustchain tube
and no complication occurs as a rule
It is characterized by the presence
and destructive cholesteatoma which
spread beyond the middle ear def and
causing threatening complication.
Aetiology :
1. Age : It occurs at any age.
2. Sex : Both sexes equally affected
3. Predisposing Factors :
a. Acute Otitis media
b. Acute Necrotic Otitis media
c. Traumatic Perforation
d. Refraction
e. Congenital cholesteatoma
 4. Causative Organism : likes streptococci, Pneumococci,
staphylococci, Bacillus Fragilis and bacillus coli.
5. General Factors :
a. Unhygenic conditions
b. Poverty and undernourishment
Clinical Features :
1. Otorrhoea : It is presenting symptoms of chronic suppurative otitis
media.
2. Deafness : Mild to moderate degree. Very severe deafness may be due
to the spread of infection to the labyrinth with attico antral disease
causing sensori-neural deafness.
3. Ear Ache : An uncomplicated chronic otitis media in free from
earache.
4. Tinnitus : may be present and difficult to treat.
5. Giddiness : may be present because of a complication like
labyrinthitis.
6. Bleeding : Blood stained discharge may be present because of
granulation or polyps.
7. Swelling : The swelling due to the mastoid abscess. The swelling
shows sign of acute infection and the pinna is pushed outwards,
downwards and forwards. This is described as erection of pinna.
8. Complications :
Signs
1. Perforation
2. Tenderness
3. Complications
Investigations:
1. Hearing tests
2. Bactoriological examination
3. radiology of the mastoid
4. CT scan
5. Otomicroscopy
6. Examination of the CNS
Differential Diagnosis :
1. Acute Otitis Media
2. Acute Necrotic Otitis media
3. Traumatic Perforation
4. Otitis externa
5. Tuberculous otitis media
6. Non-suppurative otitis media.
Homoeopathic Management:
Homoeopathic Remedies :
1. Ars Iodine
2. Cal. Carb
3. causticum
4. Kali bich
5. kali sulph
6. silicea
7. sulphur
8. thuja occi
9. merc. S.
10.Pulsetilla
Complications of Otitis Media :
Infection of the middle ear should not be neglected or else it may lead
to serious problems.
Complications of otitis media may result from both acute and chronic
otitis media.
The complication and otitis media classified as below,
Complications of Otitis media

I. Matoid Infection II. Extracranial III. Intracranial

Complications Complications
1. Petrositis 1. Extradural
2. Facial Nerve Abscess
Palsy 2. Subdural Abscess
3. Labyrinthitis meningitis
Mastoiditis
3. sigemoid sinus
thrombophebitis
4. Brain Abcess
5. Otitic
A. Acute Mastoid Hydrocephalus
i. Catarrhal Abscess
ii. Coalescent i. superiosteal
B. Chronic abcess
Mastoidtis ii. Bezolds
abscess
iii.zyngomati
c
abscess
iv. Lucs
abscess
v. Citelis
abscess
Merc. Sol :
It is indicated in infection of the joints.
 Suppuration in the joints which is bloody pus like.
 Along with joint infection there is fever but this is very typical it is
with creeping chilliness.
 Every little injury suppurates.
 Patient is very thirsty. Intense thirst for large quantity of cold water
although tongue is moist, salivated , flabby.
 All complaints are < from sun set to sun rise.
 All discharges are very offensive.
 Mentally patient with weak memory, loss of will power slow and
sluggish in giving the amwerm.
 A/F : Abuse of crude mercurial preparations bad effects of sugar
suppressed tool sweat vapour arsenic or copper, suppressed
gonorrhoea and syphilis.
 Modalities
< at night ,damp weather, lying on right side.
> Rest, coitus, weeping.

Psorinium :
 It is a nasode indicated in all type of a skin infection vital and
bacterial infection.
 Dirty, dirty look
 Intolerable itching.
 Worse from warmth of bed, thighly chilly patient.
 Eczema behind the ear
 Urticaria after every exertion
 Pustules near finger-nalls
 Fever – In fever offensive perspiration, night siveats.
 We can prescribe this as a preventive in all type of skin infection.
 Modalities ,
< worse coffee, worse changes in weather.
Dread of least cold air or draft
> Heat, warm clothing summer.