Publication:

Clinical profile and associated risk factors of chronic suppurative otitis media in a tertiary care centre: a cross-sectional study

Background Chronic suppurative otitis media (CSOM) remains a major cause of preventable hearing loss in low- and middle-income countries and is closely associated with poverty, overcrowding, recurrent upper respiratory infection, undernutrition and delayed access to treatment. To evaluate the clinical profile and associated risk factors of CSOM in patients attending a tertiary care centre.

Methods This hospital-based cross-sectional observational study included 384 patients with clinically diagnosed CSOM. Data were collected using a predesigned semi-structured proforma incorporating demographic characteristics, symptom profile, otoscopic findings, associated ENT conditions, hearing assessment and environmental or behavioural risk factors. Statistical analysis included descriptive statistics and multivariate analysis to identify independent predictors of severe disease.

Results The mean age of patients was 31.32±10.31 years, with the largest proportion belonging to the 31–40 years age group. Mucosal chronic otitis media was the predominant type (60.41%), while squamosal disease accounted for 39.1% of cases. Cholesteatoma was present in 44.74% of patients. Ear discharge (89.1%) and hearing loss (77.6%) were the most common presenting complaints. Conductive hearing loss was the commonest audiological pattern (71.88%). Low socioeconomic status, malnutrition, bottle feeding, overcrowding, indoor cooking exposure and upper respiratory tract infection showed significant association with severe disease. On multivariate analysis, low socioeconomic status, malnutrition, bottle feeding, overcrowding and indoor cooking exposure remained independent predictors of squamosal disease.

Conclusions CSOM in this tertiary care population showed a substantial burden of hearing loss and unsafe disease. Severe disease was strongly associated with modifiable social and environmental determinants, highlighting the need for early diagnosis, hearing assessment, management of associated upper airway disease and preventive community-level interventions.