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Is There Any Non Surgical Treatment For Chronic Suppartive Otitis Media

Posted on Thu, 26 Mar 2015

Question: Dear Dr.

Question:

Is there perhaps a non-surgical treatment alternative for Chronic Suppurative Otitis Media in a 17-year old, otherwise very healthy boy?

Background:

After complaining of not hearing well on his left ear, our boy was referred to an audiologist and then to otolaryngologist. Audio test showed aprox. 40 dB hearing loss in the affected left ear. Recent (Feb.2015) CT scan of temporal bones showed an inflamed middle ear with thick mucus. OLR specialist observed two smaller polypoid growths in mastoid cavity and is suspecting a presence of CHOLESTEATOMA. The boy has no clinical signs of any pain, there's no smelly discharge from the ear and he is not complaining of headaches. Recent basic blood test showed all levels within normal ranges. OLR specialist suggested an operation in XXXXXXX of 2015 to determine final diagnosis. The MRI scan will also be performed, but only a few weeks before the operation date.

Are there any other diagnostic alternatives to determine the presence of cholesteatoma?
Also, is there perhaps a non-surgical alternative to "drain" the mucus from the affected ear?

Thank you very much in advance for your opinion.

Best Regards,

XXXXXXX

Answered by Dr. Satvinder Bakshi (26 minutes later)

Brief Answer:
surgery is the best option

Detailed Answer:
Hello

I can understand your concern and reluctance for surgery , but please remember that cholesteatoma is a cause of concern and will constantly keep eroding the structures around it.

Already there is a hearing loss of 40 dB and it is only going to worsen as the cholesteatoma will keep eroding surrounding structures and middle ear ossicles leading to more hearing loss.

There is a further added risk of the infection spreading into the cranial cavity and causing a brain infection , although this is very rare.

There is no role for conservative management and delaying the procedure will only lead to more complications.

Please dont worry as the surgery is not very complicated and the complications in good hands are minimal. please go ahead with the surgery as it is the best and right option.

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Satvinder Bakshi (25 minutes later)

Thank you for your explanation Dr. Bakshi.
Since the AOM diagnosis only suspects the presence of holesteatoma... Is there any possibility the polipoid growt might be only a "swelling due to" middle ear infection?
Thank you,
XXXXXX

Answered by Dr. Satvinder Bakshi (28 minutes later)

Brief Answer:
yes it is possible

Detailed Answer:
Hello

I dont deny what you are saying is wrong , but still i am worried about the hearing loss and generally mucosal edema will be diffuse and not seen as polyps!

The presence of polyps and hearing loss indicates that he infection/cholesteatoma/disease has spread into the mastoid and middle ear and definitely needs to be evaluated and removed.

Please dont be afraid!

take care!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Satvinder Bakshi (43 minutes later)

Thank you Dr. Bakshi!
Since the surgery is already scheduled for XXXXXXX (due to wIting period and due to boy not loosing too much of school attendance) would you perhaps advice an earlier operation or it's OK to waith until June?
Thank you,
XXXXXX

Answered by Dr. Satvinder Bakshi (49 minutes later)

Brief Answer:
it is ok to wait for sometime.

Detailed Answer:
Hello

i can understand your concern , but it is ok to wait fro a few months as it is not an emergency and i would also not like the kid to miss his school.

please remember the disease progresses very slowly over many years , therefore waiting for few months will not be an issue.

Take care!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Satvinder Bakshi (8 hours later)

Great, thank you. We were told the boy will need to stay in the hospital for one week after the operation. Is this an established hospitalization time-frame in your practice?
Thanks,
XXXXXX

Answered by Dr. Satvinder Bakshi (1 hour later)

Brief Answer:
yes its an established norm

Detailed Answer:
Hello

The protocol may vary from hospital to hospital , but definitely 4-6 days post surgical admission is required , for proper healing and better results!

Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Satvinder Bakshi (13 hours later)

Thank you very much Dr.Bakshi!
Kindest Regards,
XXXXXX

Answered by Dr. Satvinder Bakshi (13 hours later)

Brief Answer:
its my pleasure!

Detailed Answer:
hello

its my pleasure!

thanks

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar