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      Chronic suppurative otitis media

      Repeated ear infections can cause discomfort and hearing loss and, in rare cases, may even lead to cholesteatoma.

      Chronic suppurative otitis media (CSOM) is inflammation of the middle ear with recurring fluid discharge that is usually the result of repeated episodes of otitis media (middle ear infection). Your eardrum can fail to heal, leaving a permanent perforation (hole).


      If a perforation develops in the upper (attic) region of your ear drum it can be more problematic because your eardrum sheds dead skin, which can build up and enter the middle ear. This skin can then mix with wax and other debris to form a cyst-like mass. This mass is known as a cholesteatoma, which if left untreated can get bigger; causing damage to nearby parts of the ear, such as the eardrum and ossicles. This condition causes very smelly discharge to leak from your ear; you may have hearing loss; tinnitus and if your balance system in the inner ear are damaged you will have vertigo.

      Occasionally, the cholesteatoma can damage the bone covering the nerve that supplies your face, which can weaken your facial muscles. In very severe cases, it may even wear through your skull, causing meningitis or brain infections. Signs that damage is taking place include vertigo, weakness of the facial muscles and bad headaches.

      How is CSOM treated?

      If you have CSOM, your GP will refer you to an ear, nose and throat (ENT) specialist for treatment. If you have a cholesteatoma, you’ll need an operation to remove the abnormal skin growth and all traces of infection to prevent it from causing damage to the middle ear and even the inner ear. The surgeon will then try to rebuild the damaged middle ear, graft the eardrum and, if possible, restore your hearing.

      Do you have earache and hearing loss after a middle ear infection or injury, or have you experienced a sudden loud noise and air pressure change?

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