Abstract

AYURVEDIC MANAGEMENT OF CHRONIC SUPPURATIVE OTITIS MEDIA (CSOM): A CONCEPTUAL AND INTEGRATIVE REVIEW WITH PAEDIATRIC CONSIDERATIONS

Dr. Suchita Kanade*, Dr. Indrajeet S. Gadge, Dr. Sachin Umbardand

Abstract

Background: Chronic Suppurative Otitis Media (CSOM) is a persistent inflammation of the middle ear characterized by recurrent otorrhea through a tympanic membrane perforation. It predominantly affects pediatric populations and remains a significant cause of preventable hearing loss worldwide. Ayurveda describes analogous conditions under Karnaroga, particularly Karna Srava and Putikarna, offering holistic therapeutic strategies. Objective: To critically review the Ayurvedic understanding and management of CSOM, correlate it with modern otology, integrate pediatric (Kaumarbhritya) considerations, and propose an evidence-backed holistic treatment framework. Methods: A systematic literature review was conducted using PubMed, Google Scholar, DHARA, AYUSH Research Portal, and classical Ayurvedic texts (Charaka, Sushruta, Ashtanga Hridaya, Kashyapa Samhita). Keywords included: CSOM, Ayurveda, Karnaroga, Karna Srava, Karna Shoola, Karna Purana, pediatric otitis media. Commentaries and Nighantus were analyzed for conceptual clarity. Relevant modern ENT guidelines and research studies were included. Results: Ayurveda attributes CSOM-like conditions to Kapha-Pitta vitiation, krimi, srotodushti, and improper ear hygiene. Classical Ayurvedic therapies including Karna Purana, Dhoopana, Kashaya Prayoga, Shamana drugs (Triphala, Haridra, Yashtimadhu), and Rasayana showed significant therapeutic potential. Pediatric-specific modifications emphasize gentle Shamana therapy, immune support, safe Karna Purana, management of recurrent URTI, and dietary corrections. Integrative protocols combining modern antibiotics with Ayurvedic interventions yield improved mucosal healing, reduced recurrence, and lower antibiotic resistance. Conclusion: Ayurveda offers a comprehensive framework for managing CSOM through anti-inflammatory, antimicrobial, immunomodulatory, and tissue-healing therapies. Paediatric-focused interventions strengthen immunity, reduce recurrence, and support normal hearing and speech development. Integrative management holds promise for addressing chronicity, recurrence, and antibiotic resistance.

Keywords: CSOM, Chronic Suppurative Otitis Media, Karnaroga, Karna Srava, Karna Purana, Ayurveda, Paediatric Otitis Media, Kapha-Pitta Dushti, Rasayana, Integrative Otology.