Aural toilet (ear cleaning) for chronic suppurative otitis media

This is the first update of a Cochrane review published in 2020. Chronic suppurative otitis media (CSOM), sometimes referred to as chronic otitis media, is a chronic inflammation and often polymicrobial infection of the middle ear and mastoid cavity, characterised by ear discharge (otorrhoea) through a perforated tympanic membrane. The predominant symptoms of CSOM are ear discharge and hearing loss. Aural toileting describes processes for manually cleaning the ear, including dry mopping (with cotton wool or tissue paper), suction clearance (typically under a microscope), or irrigation (using manual or automated syringing). Aural toileting can be used alone or in addition to other treatments for CSOM, such as antibiotics or topical antiseptics. This is one of a suite of seven Cochrane reviews evaluating the effects of non-surgical interventions for CSOM.

Citation:
Bhutta MF, Head K, Chong LY, Daw J, Schilder AG, Brennan-Jones CG. Aural toilet (ear cleaning) for chronic suppurative otitis media. Cochrane Database Syst Rev. 2025;6(6):Cd013057.

Keywords:
Anti-bacterial agents; therapeutic use; bias; child; chronic disease; otitis media; suppurative; quality of life; randomized controlled trial

Abstract:
This is the first update of a Cochrane review published in 2020.
Chronic suppurative otitis media (CSOM), sometimes referred to as chronic otitis media, is a chronic inflammation and often polymicrobial infection of the middle ear and mastoid cavity, characterised by ear discharge (otorrhoea) through a perforated tympanic membrane. The predominant symptoms of CSOM are ear discharge and hearing loss. Aural toileting describes processes for manually cleaning the ear, including dry mopping (with cotton wool or tissue paper), suction clearance (typically under a microscope), or irrigation (using manual or automated syringing). Aural toileting can be used alone or in addition to other treatments for CSOM, such as antibiotics or topical antiseptics. This is one of a suite of seven Cochrane reviews evaluating the effects of non-surgical interventions for CSOM.