INTERNATIONAL JOURNAL OF ARTIFICIAL INTELLIGENCE
ISSN: 2692-5206, Impact Factor: 12,23
American Academic publishers, volume 05, issue 06, 2025
https://www.academicpublishers.org/journals/index.php/ijai
page 1253
MODERN TREATMENT APPROACHES AND MANAGEMENT OF
COMPLICATIONS IN CHRONIC OTITIS MEDIA
Komolidinov Bobur
Assistant, Department of Surgical Diseases, Central Asian Medical University, Fergana,
Uzbekistan
Otaqulov Otabek
Assistant, Department of Surgical Diseases, Central Asian Medical University, Fergana,
Uzbekistan
Tokhirjon Abdunazarov
Assistant, Department of Surgical Diseases, Central Asian Medical University, Fergana,
Uzbekistan
Abstract
Chronic otitis media (COM) is a prolonged inflammatory process involving the tissues of the
middle ear cavity, often characterized by hearing loss, purulent discharge, and tympanic membrane
damage. This article highlights modern conservative and surgical treatment methods for COM.
Additionally, it examines therapeutic strategies for complicated cases such as labyrinthitis,
intracranial infections, and facial nerve paralysis. Timely and comprehensive treatment not only
reduces the consequences of the disease but also significantly improves the patient’s quality of
life.
Keywords
Chronic otitis media, tympanoplasty, cholesteatoma, labyrinthitis, intracranial complications,
hearing loss, antibiotic therapy.
Introduction
Chronic otitis media (COM) affects millions of individuals worldwide and is among the leading
causes of disability. According to the WHO, COM is prevalent in both children and adults in
developing countries, often being either undiagnosed or diagnosed late. The chronic form of the
disease is characterized by persistent inflammation, destruction of middle ear structures, tympanic
membrane
defects,
and
sustained
hearing
loss.
Modern otorhinolaryngology offers a wide range of conservative, surgical, and complex
approaches to effectively treat this condition.
1. Conservative Treatment
In mild to moderate forms of COM, conservative management is key. The following therapeutic
interventions
are
applied:
- Antiseptic irrigation using furacilin, miramistin, or hydrogen peroxide solutions.
-
Topical
antibiotics:
ofloxacin,
ciprofloxacin,
levofloxacin
drops.
INTERNATIONAL JOURNAL OF ARTIFICIAL INTELLIGENCE
ISSN: 2692-5206, Impact Factor: 12,23
American Academic publishers, volume 05, issue 06, 2025
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-
Combination
drugs
with
corticosteroids:
Polydexa,
Sofradex.
- Systemic antibiotics: amoxicillin-clavulanate, ceftriaxone, levofloxacin (IV for severe or
complicated
cases).
- Physiotherapy: UHF, laser therapy, electrophoresis to reduce inflammation and accelerate
regeneration.
2. Surgical Treatment
-
Tympanoplasty
– reconstruction of the tympanic membrane and ossicles.
-
Mastoidotomy
and
mastoidectomy
–
removal
of
infected
bone
tissue.
- Placement of ventilation tubes – for middle ear effusion.
3. Management of Complicated Cases
3.1.
Labyrinthitis
(inner
ear
inflammation):
-
Symptoms:
severe
vertigo,
hearing
loss,
vomiting.
-
Treatment:
intravenous
antibiotics,
corticosteroids,
betahistine.
3.2.
Intracranial
Complications
(meningitis,
brain
abscess):
-
Symptoms:
fever,
headache,
neck
stiffness,
altered
consciousness.
- Treatment: urgent hospitalization, broad-spectrum antibiotics (vancomycin, ceftriaxone,
meropenem),
neurosurgical
intervention.
3.3.
Facial
Nerve
Paralysis:
-
Symptoms:
facial
muscle
paralysis,
asymmetry.
- Treatment: corticosteroids, antiviral therapy (if herpes-related), facial nerve decompression.
Facial
Nerve
Paralysis
(n.
facialis
paresis):
Facial nerve paralysis in chronic otitis media is a rare but serious complication resulting from
inflammation or pressure on the nerve as it traverses the bony canal. Clinical presentation includes
unilateral facial muscle paralysis, loss of facial expressions, and incomplete eyelid closure
(lagophthalmos).
Corticosteroid
Therapy:
- Goal: to reduce nerve swelling and inflammation, and accelerate regeneration.
- Prednisolone: high doses initially (e.g., 1 mg/kg/day or ~60 mg/day) for 5–7 days, then gradual
tapering
over
5–10
days.
-
Methylprednisolone
(Medrol):
48–64
mg/day
with
tapering
over
5–7
days.
Additional
Treatment:
-
B
vitamins
(B1,
B6,
B12)
for
nerve
regeneration.
-
Physiotherapy
–
facial
muscle
electrostimulation,
massage.
-
Artificial
tears
and
eye
hygiene
to
prevent
dryness.
- Antiviral therapy – if viral etiology (e.g., Herpes zoster oticus) is suspected (acyclovir 800 mg,
INTERNATIONAL JOURNAL OF ARTIFICIAL INTELLIGENCE
ISSN: 2692-5206, Impact Factor: 12,23
American Academic publishers, volume 05, issue 06, 2025
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page 1255
5×/day
for
7
days).
- Surgical decompression – for severe cases unresponsive to corticosteroids or when the nerve is
compressed
by
bone.
3.4.
Cholesteatoma:
-
Symptoms:
persistent
discharge,
hearing
loss,
bone
erosion.
- Treatment: only surgical – radical tympanoplasty, mastoidectomy.
Conclusion
Modern management of chronic otitis media should be complex, individualized, and stepwise.
While conservative therapy effectively manages mild cases, surgical procedures performed by
specialists are crucial in severe or complicated conditions. Timely diagnosis, adequate treatment
planning, and preventive measures reduce the risk of complications and preserve the patient’s
hearing function.
References
1. World Health Organization. (2021). Chronic suppurative otitis media: Burden of illness and
management options.
2. Bluestone CD, Klein JO. Otitis Media in Infants and Children. 5th ed. PMPH-USA; 2007.
3. Jackler RK, Santa Maria PL. Otologic Surgery. Elsevier; 2022.
4. Kazantsev AP, Kozlov VS. Clinical Otorhinolaryngology. Moscow: GEOTAR-Media; 2018.
5. Asher E, Horlbeck D. Current management of chronic otitis media and complications.
Otolaryngol Clin North Am. 2020;53(4):613-630.
6. Roland PS, Marple BF. Contemporary management of chronic suppurative otitis media. Curr
Opin Otolaryngol Head Neck Surg. 2022;30(1):21-26.
