Chronic Suppurative Otitis Media Workup

  • Author: David Parry, MD; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Oct 13, 2011
 

Approach Considerations

Reasonable chronic suppurative otitis media (CSOM) treatment plans can be developed without lab studies. Prior to instituting systemic therapy, a culture should be obtained for sensitivity.

If CSOM is unresponsive to medical treatment, a fine-cut CT scan of the temporal bone may provide an explanation. A fine-cut CT scan may reveal bone erosion from a cholesteatoma, ossicular erosion, involvement of the petrous apex, coalescent mastoiditis, erosion of the fallopian canal, and a subperiosteal abscess. Possible reasons for failed treatment include an occult cholesteatoma or a foreign body.

CT scanning is a necessary adjunct to treatment if the clinician suspects a neoplasm or anticipates intratemporal or intracranial complications.

MRI scans of the temporal bone and brain should be obtained if intratemporal or intracranial complications are suspected. By clearly depicting soft tissues, MRI can reveal dural inflammation, sigmoid sinus thrombosis, labyrinthitis, and extradural and intracranial abscesses.

An audiogram should be performed. Conductive hearing loss is expected, but mixed hearing loss may indicate more extensive disease and should alert the treating physician of impending complications.

Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

David Parry, MD  Staff Physician, Department of Otolaryngology-Head and Neck Surgery, ENT Associates of Children's Hospital, Boston

Disclosure: Nothing to disclose.

Coauthor(s)

Peter S Roland, MD  Professor, Department of Neurological Surgery, Professor and Chairman, Department of Otolaryngology-Head and Neck Surgery, Director of Clinical Center for Auditory, Vestibular and Facial Nerve Disorders, Chief of Pediatric Otology, University of Texas Southwestern Medical Center; Adjunct Professor of Communicative Disorders, University of Texas School of Human Development

Peter S Roland, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American Auditory Society, American Laryngological Rhinological and Otological Society, American Neurotology Society, American Otological Society, North American Skull Base Society, and Society of University Otolaryngologists-Head and Neck Surgeons

Disclosure: Alcon Labs Honoraria Speaking and teaching; GSK Honoraria Speaking and teaching; Advanced Bionics Honoraria Board membership; Cochlear Corp Honoraria Board membership; Med El Corp travel grants Consulting

Chief Editor

Arlen D Meyers, MD, MBA  Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo Consulting; Medvoy Ownership interest Management position; Cerescan Imaging Honoraria Consulting; GYRUS ACMI Honoraria Consulting

Additional Contributors

Anurag Jain, MBBS, FRCS(Ire), MS, FRCS(Oto), MS(Oto), DLO(RCSEngland) Specialist Registrar, Department of Otolaryngology, Pinderfields General Hospital, Wakefield, UK

Anurag Jain, MBBS, FRCS(Ire), MS, FRCS(Oto), MS(Oto), DLO(RCSEngland) is a member of the following medical societies: Association of Otolaryngologists of India, British Association of Otorhinolaryngologists, Head and Neck Surgeons, British Medical Association, Royal College of Surgeons in Ireland, and Royal College of Surgeons of England

Disclosure: Nothing to disclose.

Jeffrey Robert Knight, MBChB, FRCS Consulting Surgeon, Department of Otolaryngology, Mayday University Hospital, London

Disclosure: Nothing to disclose.

John C Li, MD Private Practice in Otology and Neurotology; Medical Director, Balance Center

John C Li, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Neurotology Society, American Tinnitus Association, Florida Medical Association, and North American Skull Base Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Peter A Weisskopf, MD Neurotologist, Arizona Otolaryngology Consultants; Head, Section of Neurotology, Barrow Neurological Institute

Peter A Weisskopf, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery and American College of Surgeons

Disclosure: Nothing to disclose.

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