Echoes of neglect – the pediatric burden of chronic otitis media

Abstract

Background: Chronic otitis media (COM) is a major cause of morbidity among children, particularly in developing regions, where socioeconomic and environmental factors contribute to its high prevalence. This study aimed to evaluate the prevalence, clinical profile, predisposing factors, and management of COM among pediatric patients.

Methods: This cross-sectional, hospital-based study was conducted over one year (April 2025-March 2026) in the ear, nose, and throat (ENT) outpatient department. A total of 200 pediatric patients aged 5-15 years diagnosed with COM were enrolled. Demographic characteristics, clinical presentation, and predisposing factors were recorded using a structured questionnaire. All patients underwent otoscopic examination and tuning-fork tests. Data were analyzed using statistical package for the social sciences (SPSS).  

Results: Of 1,740 pediatric patients screened, 200 were diagnosed with COM, giving a hospital-based prevalence of 11.49%. There was a male predominance, with a male-to-female ratio of 1.44:1. The highest proportion of cases occurred in the 8-10-year age group. Ear discharge was the most common symptom (72%), followed by ear pain (14%) and hearing loss (12%). Unilateral disease predominated, and central tympanic membrane perforation was the most frequent otoscopic finding. Objective hearing impairment was detected in 68 patients (34%) and showed a significant association with the duration of symptoms (p<0.05). Management was predominantly medical, including antibiotics, topical ear drops, and nasal decongestants.

Conclusions: Pediatric COM remains a significant cause of morbidity and hearing impairment. Modifiable factors such as poor hygiene and bathing in open ponds highlight the need for community awareness, health education, and improved living conditions in rural areas. Early diagnosis and appropriate treatment are essential to prevent long-term complications.