Background. Chronic suppurative otitis media (CSOM) remains a major public health concern affecting both children and adults, particularly in low- and middle-income countries. The disease requires complex medical and surgical management and imposes a substantial socioeconomic burden because of its association with hearing impairment and potentially life-threatening complications.
Material and Methods. A comprehensive literature search was conducted using the PubMed, HINARI, SpringerLink, National Center for Biotechnology Information (NCBI), and MEDLINE databases. Publications published between 2000 and 2024 were identified using the keywords “chronic otitis media” and “chronic suppurative otitis media” combined with terms related to surgical treatment, mastoidectomy, canal wall-down, canal wall-up, canal wall-intact, canal wall reconstruction, tympanoplasty, and ossiculoplasty. Relevant studies meeting predefined selection criteria were critically reviewed and synthesized.
Results. Chronic suppurative otitis media is a chronic inflammatory disease of the middle ear cleft characterized by persistent or intermittent otorrhea, permanent tympanic membrane perforation, and progressive conductive or mixed hearing loss. Prevalence is below 1% in high-income countries but ranges from 7% to 46% in low-income regions. Diagnosis is based on clinical history, otoscopic examination, audiological assessment, microbiological investigations, and high-resolution imaging when indicated. Surgical management includes canal wall-down (CWD) and canal wall-up (CWU) techniques. CWD provides excellent surgical exposure and superior cholesteatoma eradication but is associated with open cavity-related disadvantages. CWU better preserves external auditory canal anatomy and hearing outcomes, although residual and recurrent cholesteatoma are more common. Contemporary strategies increasingly incorporate mastoid obliteration and canal wall reconstruction
to minimize postoperative cavity-related complications.
Conclusions. CSOM management should be individualized according to disease extent, anatomical and radiological findings, hearing status, associated pathology, complications, and patient-related factors to optimize disease control and functional outcomes.
ISSN-online 2360-2473 / ISSN-print 1223-0472
