title: Medical management of chronic suppurative otitis media without cholesteatoma in children.
abstract: Tympanomastoid surgery is considered standard management for chronic suppurative otitis media (CSOM) without cholesteatoma, which is unresponsive to ototopical/oral antimicrobial therapy. The following makes this sequence of management less attractive today: 1. potential ototoxicity of ototopical agents; 2. lack of oral antimicrobial agents effective against most common pathogens (e.g., Pseudomonas aeruginosa); 3. frequent occurrence in children who have tympanostomy tubes; and 4. failure of tympanomastoid surgery to eradicate the disease in all cases. We conducted a study in 36 pediatric patients with chronic suppurative otitis media, in which all received parenteral antimicrobial therapy and daily aural toilet (mean duration of treatment = 9.7 days). Thirty-two patients (89%) had resolution of their infection with medical therapy alone; four children required tympanomastoidectomy. Further investigation is needed to understand the etiology, pathogenesis, and most effective methods of management/prevention of CSOM in children.
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001299:Audiometry; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D002781:Cholesteatoma; D002908:Chronic Disease; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D004427:Ear Diseases; D004432:Ear, Middle / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D010033:Otitis Media / Q000188:drug therapy*; D010035:Otitis Media, Suppurative / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D011446:Prospective Studies; D011859:Radiography; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents