Etiology of COM

 

 

Acute otitis media and otitis media with effusion:

Acute otitis media and otitis media with effusion can cause long term changes in the ear drum. Histological degeneration of the ear drum occurs in the outer and inner fibrous layers of lamina propria and in the submucosal layer. These changes may reduce the elastic properties of the ear drum making it more susceptible to chronic perforation or retraction.

Genetics and race:

Incidence of COM varies in different population. The role of genetic factors playing a role in the pathogenesis of COM is rather difficult to elucidate with the present knowledge.

Environment:

Pollution and incidence of URI have a role to play in the pathogenesis of COM

Eustachean tube dysfunction and URI:

Eustachean tube dysfunction is more common in patients with COM. This is common in patients with skull base deformities.

GERD:

Secretions from the middle ear cavity was found to be rich in pepsiongen which could have come only from the stomach.

Allergy:

Predisposes to nasal block and eustachean tube dysfunction

Immune deficiency:

This is another probable cause for COM