Chronic suppurative otitis media.

Chronic suppurative otitis media (CSOM) is a leading global cause of potentially preventable hearing loss in children and adults, associated with socioeconomic deprivation. There is an absence of consensus on the definition of CSOM, which complicates efforts for prevention, treatment, and monitoring. CSOM occurs when perforation of the tympanic membrane is associated with severe or persistent inflammation in the middle ear, leading to hearing loss and recurrent or persistent ear discharge (otorrhoea). Cholesteatoma, caused by the inward growth of the squamous epithelium of the tympanic membrane into the middle ear, can also occur. The optimal treatment of discharge in CSOM is topical antibiotics. In resource-limited settings where topical antibiotics might not be available, topical antiseptics are an alternative. For persistent disease, surgery to repair the tympanic membrane or remove cholesteatoma might offer long-term resolution of otorrhoea and potential improvement to hearing. Recent developments in self-fitted air-conduction and bone-conduction hearing aids offer promise as new options for rehabilitation.
Competing Interests: Declaration of interests MFB serves in honorary roles as consultant to the WHO Programme for the Prevention of Deafness and Hearing Loss, council member of the British Society of Otology, and board member of the Children's Surgical Centre, Cambodia; he has received research grants to his institution from the National Institute for Health and Care Research, ENT UK, and Karl-Storz UK. AJL and CGB-J are members of the Australian Otitis Media Guidelines Technical Advisory Group. AJL has received research grants to her institution from philanthropy, the Northern Territory and Australian Governments, and Merck Sharp & Dohme. CGB-J is supported by funding from the Government of Western Australia Department of Health and the National Health and Medical Research Council.
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