Chronic Suppurative Otitis Media | CSOM

Chronic Suppurative Otitis Media or CSOM is a long-standing infection of a part or whole of the middle ear cleft characterized by Ear discharge and a permanent Perforation. A perforation becomes permanent when its edges are covered by squamous epithelium and it does not heal spontaneously. A permanent perforation can be likened to an epithelium-lined fistulous track.

Wordwise Meaning of CSOM:

  • Chronic- Long-standing
  • Suppurative- Related to pus (containing or discharging pus)
  • Otitis- Inflammation of the ear
  • Media- Middle ear

Types of CSOM

Clinically, it can be divided into two types:-


  • Also called the safe or benign type.
  • It involves the anteroinferior part of the middle ear cleft,i.e, the eustachian tube and mesotympanum.
  • It is associated with central perforation.
  • There is no risk of serious complications.


  • Also called unsafe or dangerous type.
  • It involves the posterosuperior part of the middle ear cleft, i.e, attic, antrum, and mastoid.
  • It is associated with an attic or marginal perforation.
  • This disease is often associated with a bone-eroding process such as cholesteatoma, granulation, or osteitis, and the risk of complication is very high.

Difference between Atticoantral and Tubotympanic CSOM

tubotympanic vs atticoantral csom
Difference between Tubotympanic and Atticoantral CSOM
Features Tubotympanic Atticoantral
Discharge Profuse Mucoid




Foul Smelling

Perforation Central Attic/Marginal
Granulation Uncommon Common
Polyp Pale Red and fleshy
Cholesteatoma Absent Present
Complications Rare Common
Audiogram Mild to moderate conductive deafness Conductive deafness or mixed deafness
polyp in ear canal csom
Polyp in Ear Canal in CSOM

This was in general about Chronic Suppurative Otitis Media. There are two types- Tubotympanic and Atticoantral CSOM.

Related Articles


Please enter your comment!
Please enter your name here