Background: Permanent perforation in the eardrum with persistent drainage from middle ear for more than six weeks is labelled as chronic suppurative otitis media. The major disability of long standing chronic suppurative otitis media presents as disability in hearing thresholds both in young children and adults. The disease has a fewer prevalence in urban regions and mostly is found in the rural population. Aim: To identifying the Prevalence of hearing loss which is sensorineural in patients having middle ear chronic infection (CSOM). Study design & setting: Cross-sectional survey conducted in the department of ENT, Jinnah Hospital Duration/date of the study: 01st February 2020 to 31STJuly 2020 Methods: A Total number of 180 patients were included as a sample in the study. Keeping the level of confidence to 95% and keeping the margin of error to minimum to 5%. These statistics were generated keeping the frequency level of hearing in these patients to minial of 16%. The sampling technique would be non probability type of sampling with a purpose. Results: The results of the study concluded that patients of both sex ranged between first decade and fifth decade. A total of 180 patients had 114 male gender and 66 female gender patients. Patients having chronic middle ear disease were segregated into CSOM (tubo tympanic) with 137 patients and CSOM (attico antral) with 43 patients. The primary indicator of hearing loss in these patients however showed 23 patients having a hearing loss of sensori neural type and 157 patients did not have any sensori neural hearing loss. Conclusions: This research study draws a conclusion that majority cases of chronic middle ear infection is usually the safe type (Tubo tympanic) while a very fewer of these patients of CSOM would have (Attico antral) or dangerous type of CSOM. The major variable of the research, in the form of hearing loss which was sensori neural in patients presenting with CSOM was (12.8%). This percentage is much lower when compared with conductive hearing loss in CSOM. Keywords: Otitis media of chronic type with suppuration, pure tone audiometry, sensory neural hearing loss

Background: Prior to surgical management of chronic suppurative otitis media (CSOM) for the dry ear medical management is necessary. CSOM is a biofilm disease and due to this has antibiotic resistance. The pillar of its treatment included aural cleaning according to standard protocols, application of topical germ free antiseptic and use of antimicrobials. Acetic acid due to its ability in reducing the pH may be effective in reducing the growth of microorganisms. Objective: The aim of the study was to compare the efficacy of irrigation with acetic acid versus systemic antibiotics in CSOM patients. Materials & Methods: A total of 134 patients, who came to the ENT department of Sheikh Zayed Hospital, Lahore between 1st April 2020 to 30th September 2020, who had CSOM, of age 15 to 55 years and both genders were included in the study. The patients were divided randomly into two groups. Group A patients received aural toilets and irrigation with acetic acid and Group B received 500 mg of ciprofloxacin twice a day for 2 weeks. Results: The mean age (in years) of the patients in Group A was 37.45±7.32 and in Group B, it was 37.96±7.57. The efficacy of irrigation with acetic acid versus systemic antibiotics was 89.55% and 68.66% respectively and this difference between the two groups was found to be statistically significant (p=0.003). Conclusion: Irrigation with acetic acid was better than systemic antibiotics in managing patients with CSOM. Key words: Acetic acid, CSOM, Middle ear