Chronic suppurative otitis media

Chronic suppurative otitis media is an inflammatory condition of the middle ear. The presence of a tympanic membrane perforation or a tympanostomy tube allows drainage into the external ear canal. Increased vascularity of the mucosa and submucosa, combined with acute and chronic inflammatory cells, is its hallmark. Granulation tissue, fibrosis, and osteoneogenesis are also commonly present. The granulation tissue contains neutrophils and plasma cells associated with small blood vessels and fibroblasts. ... 

Cultures from patients with chronic suppurative otitis media demonstrate that the most common responsible organisms are P. aeruginosa and S. aureus. These are usually mixed infections with a variety of organisms present,and they exhibit a higher resistance to antibiotics. 

In the presence of an intact tympanic membrane, ototoxicity is less important, because the preparation has to be systemically absorbed for an ototoxic effect to occur. This issue is most relevant in cases of chronic suppurative otitis media with a perforated tympanic membrane for which the ototopical medication has the potential to reach the inner ear via the middle ear. Placed within the middle ear, ototopical medication may diffuse across the oval or round window, resulting in inner ear absorption. These windows consist of a thin membrane separating the middle ear space from the inner ear fluids. There is controversy regarding the clinical relevance of ototoxicity in cases of chronic suppurative otitis media. 

Meyerhoff, W.L. Pathology of chronic suppurative otitis media. Ann. Otolaryngol. Rhinol. Laryngol. 1998, (Suppl. 131), 21. 

Kenna, M.A. Rosane, B.A. Bluestone, C.D. Medical management of chronic suppurative otitis media without cholesteatoma in children—update 1992. Am. J. Otol. 1993, 14 (5), 469-473. 

Topical 0.2% ciprofloxacin solution was effective and well tolerated in 232 patients with chronic suppurative otitis media the most frequently reported adverse events were pruritus, stinging, and earache. Audiometric tests did not show changes attributable to ciprofloxacin (20). 

Miro N. Controlled multicenter study on chronic suppurative otitis media treated with topical applications of ciprofloxacin 0.2% solution in single-dose containers or combination of polymyxin B, neomycin, and hydrocortisone suspension. Otolaryngol Head Neck Surg 2000 123(5) 617-23. 

Ofloxacin interferes with microbial DNA synthesis. It is indicated in the treatment of acnte bacterial exacerbations of chronic bronchitis, commnnity acquired pneumonia, uncomplicated skin and skin structure infections, acute uncomplicated urethral and cervical gonorrhea, nongonococcal urethritis, cervicitis, acute pelvic inflammatory disease, uncomplicated cystitis, complicated urinary tract infections (UTI), and prostatitis cdiV eAhy Escherichia coli. Ophthalmic use for treatment of conjunctivitis and corneal ulcer infections caused by susceptible organisms otic use for treatment of otitis externa, chronic suppurative otitis media in patients with perforated tympanic membranes, and acute otitis media in pediatric patients with tympanostomy tubes. 

The antibacterial action of acetic acid in these preparations is due to a specific effect of acetic acid as well as the lowering of the pH. There are two benefits, namely that acetic acid is bactericidal to Pseudomonas aeruginosa, the major pathogen isolated from otorrhoea, and that it also suppresses several fungi [3-5]. In chronic suppurative otitis media (CSOM), the most common organism is P. aeruginosa, followed by Staphylococcus aureus. 

Chronic suppurative otitis media (CSOM) /serous otitis media (SOM) Deviated nasal septum (DNS) / polyps Tonsillitis Sinusitis... 

---