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Chronic otitis media, cholesteatoma, and mastoiditis in adults

Lawrence R Lustig, MD
Charles J Limb, MD
Rachel Baden, MD
Mary T LaSalvia, MD
Section Editor
Daniel G Deschler, MD, FACS
Deputy Editor
Daniel J Sullivan, MD, MPH


Chronic otitis media (COM) is a recurrent infection of the middle ear and/or mastoid air cell tract in the presence of a tympanic membrane perforation. Symptoms commonly associated with chronic ear disease include hearing loss, otorrhea, aural fullness, otalgia, and occasionally true vertigo.

Cholesteatoma, a keratinized mass in the middle ear or mastoid, may occur either as a primary lesion or secondary to tympanic membrane perforation. Mastoiditis may occur as a complication of acute otitis media (AOM) or COM.

AOM, an acute illness marked by the presence of middle ear fluid and inflammation of the mucosa that lines the middle ear space, is discussed separately. (See "Acute otitis media in adults".)

Similar to AOM, COM occurs far more commonly in children. These conditions in children are discussed separately. (See "Acute otitis media in children: Diagnosis" and "Acute otitis media in children: Treatment" and "Evaluation of otorrhea (ear discharge) in children", section on 'Chronic suppurative otitis media' and "Otitis media with effusion (serous otitis media) in children: Management".)


A variety of terms are used to categorize chronic infectious or inflammatory conditions of the middle ear, according to the underlying disease process and location.

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Literature review current through: Nov 2017. | This topic last updated: Apr 27, 2017.
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