Chronic otomastoiditis (COM) should be considered a separate entity from acute otomastoiditis, and is defined as persistent or recurrent inflammation of the middle ear and mastoid, lasting usually for a minimum of 12 weeks, and resulting in permanent perforation of the tympanic membrane.
It is thought to be primarily due to Eustachian tube dysfunction. Interestingly COM is not found in non-human primates. Upright posture and enlarged skull have been postulated as potential predisposing factors.
- conductive hearing loss, pain, otorrhoea, vertigo
The term encompasses a number of conditions:
- tympanic membrane changes: thickening, retraction, tympanic membrane perforation or calcification (myringosclerosis)
- mastoid process changes: underdeveloped pneumatisation, sclerosis or opacification
- middle ear changes:
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