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Predisposing factors

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The factors which predispose to a chronic suppurative otitis media include:

  • an otitis media that was not promptly treated
  • inappropriate or inadequate antibiotic therapy
  • sepsis in the upper airway
  • lowered resistance to infection, e.g. immunodeficiency, malnutrition, anaemia
  • infection with a particularly virulent virus, e.g. measles

Some populations are considered to be at high risk of CSOM:

  • high prevalence of disease among Indigenous people such as:
    • the Aboriginal and Torres Strait Islander Australian, Native American and Inuit populations - likely due to an interplay of factors, including socio-economic deprivation and possibly differences resulting from population genetics
  • individuals with primary or secondary immunodeficiency are also susceptible to CSOM
  • children with craniofacial malformation (including cleft palate) or chromosomal mutations such as Down syndrome are prone to chronic non-suppurative otitis media ('glue ear'), and by extrapolation may also be at greater risk of suppurative otitis media
    • association with craniofacial malformation may be related to altered function of the Eustachian tube, coexistent immunodeficiency, or both
  • children who have a grommet (ventilation tube) in the tympanic membrane to treat glue ear or recurrent acute otitis media may be more prone to develop CSOM


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