title: Current concepts in the pathogenesis and treatment of chronic suppurative otitis media.
abstract: Otitis media (OM) is an inflammation of the middle ear associated with infection. Despite appropriate therapy, acute OM (AOM) can progress to chronic suppurative OM (CSOM) associated with ear drum perforation and purulent discharge. The effusion prevents the middle ear ossicles from properly relaying sound vibrations from the ear drum to the oval window of the inner ear, causing conductive hearing loss. In addition, the inflammatory mediators generated during CSOM can penetrate into the inner ear through the round window. This can cause the loss of hair cells in the cochlea, leading to sensorineural hearing loss. Pseudomonas aeruginosa and Staphylococcus aureus are the most predominant pathogens that cause CSOM. Although the pathogenesis of AOM is well studied, very limited research is available in relation to CSOM. With the emergence of antibiotic resistance as well as the ototoxicity of antibiotics and the potential risks of surgery, there is an urgent need to develop effective therapeutic strategies against CSOM. This warrants understanding the role of host immunity in CSOM and how the bacteria evade these potent immune responses. Understanding the molecular mechanisms leading to CSOM will help in designing novel treatment modalities against the disease and hence preventing the hearing loss.
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Rahul
authors.initials: R
authors.lastname: Mittal
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Christopher V
authors.initials: CV
authors.lastname: Lisi
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Gerring
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Jeenu
authors.initials: J
authors.lastname: Mittal
authors.affiliation: Department of Human and Molecular Genetics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.
authors.forename: Kalai
authors.initials: K
authors.lastname: Mathee
authors.affiliation: Bioinformatics Research Group (BioRG), School of Computing and Information Sciences, Florida International University, Miami, FL, USA.
authors.forename: Giri
authors.initials: G
authors.lastname: Narasimhan
authors.affiliation: Department of Biological Sciences and Mathematics, University of North Texas, Denton, TX, USA.
authors.forename: Rajeev K
authors.initials: RK
authors.lastname: Azad
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Qi
authors.initials: Q
authors.lastname: Yao
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: M'hamed
authors.initials: M
authors.lastname: Grati
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Denise
authors.initials: D
authors.lastname: Yan
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Adrien A
authors.initials: AA
authors.lastname: Eshraghi
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Simon I
authors.initials: SI
authors.lastname: Angeli
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Fred F
authors.initials: FF
authors.lastname: Telischi
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Xue-Zhong
authors.initials: XZ
authors.lastname: Liu
mesh_terms: D002908:Chronic Disease; D006801:Humans; D057131:Immune Evasion; D010035:Otitis Media, Suppurative / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology / Q000473:pathology*; D011552:Pseudomonas Infections / Q000276:immunology / Q000382:microbiology / Q000473:pathology*; D011550:Pseudomonas aeruginosa / Q000276:immunology / Q000472:pathogenicity / Q000502:physiology; D013203:Staphylococcal Infections / Q000276:immunology / Q000382:microbiology / Q000473:pathology*; D013211:Staphylococcus aureus / Q000276:immunology / Q000472:pathogenicity / Q000502:physiology