40 Iraqi New Medical Journal | January 2023 | Volume 9 | Number 17 INTRODUCTION Chronic suppurave os media (CSOM) is defined as a persistent or intermient infected discharge through a non-intact tympanic mem- brane (TM), i.e. perforaon or tympanostomy tube. 1 Organisms isolated in chronic os media vary considerably. The predominant organisms involved are gram-negave bacilli such as pseu- domonas aeruginosa, proteus sp., and escherichia coli, anaerobes such as bacteroides fragilis, and gram-posive like staphylococcus. 2 Chronic suppurave os media (CSOM) is pathologically classified into: 3 • Inacve (mucosal) CSOM; perforaon of the TM at Pars Tensa without inflammaon. • Acve (mucosal) CSOM; perforaon, edema- tous mucosa and ear discharge. • Inacve squamous epithelium CSOM; re- tracon pockets at the Pars Flaccida. • Acve squamous epithelium CSOM (Chole- steatoma); acve mucosa with derbies and squamous retracon. • Healed chronic os media. In paents with CSOM, some have virtually Iraqi N NM M J J a MBCHB, CABMS. Otolaryngology Specialist, AL-Yarmouk Teaching Hospital, Baghdad, Iraq. b MBCHB, FIBMS. Otolaryngology Specialist, AL-Yarmouk Teaching Hospital, Baghdad, Iraq. b MBCHB, CABMS. Otolaryngology Specialist, AL-Karkh General Hospital, Baghdad, Iraq. Corresponding Author: Ahmed Salah Ahmed, AL-Yarmouk Teaching Hospital, Baghdad, Iraq. E Mail: drahmedsalah1985@gmail.com. Sensorineural hearing loss in chronic suppurative otitis media Riyadh Sagban Abdul-Aziz a , Ahmed Salah Ahmed b , Ali Abbas Ali c Research Article ABSTRACT INTRODUCTION: Chronic suppurative otitis media (CSOM) is defined as a persistent or intermittent infected discharge through a non-intact tympanic membrane (perforation or through tympanostomy tube). OBJECTIVE: Is to find the percentage of sensorineural hearing loss (SNHL) in patients with chronic suppurative otitis media and detection the correlation pathologies that increase its occurrence. METHODS: A descriptive study conducted at AL-Yarmouk Teaching Hospital & AL-Karkh General Hospital from August 2019 to April 2021. We included patients with unilateral chronic suppurative otitis media who are less than 40 years. we exclude any patients who has any medical history that potentially affect the results of this study. The outcome was pres- ence of sensorineural hearing loss which is measure using a pure tome audiometry (PTA). RESULTS: Sensorineural hearing loss detected in 24 patients (15%). The longer the duration of disease had the greater incidence of SNHL which occurred in 10 patients (6.25%), A p- value of 0.001, and the more active disease is associated with more SNHL incidence that reported in (20) patients, (12.5%) with P value = 0.05, and especially in (14) patients who had tympanic membrane (TM) perforation in attic site with percentage of (8.75%) and P value = 0.001. The incidence of occurrence of granulation tissue or polyp in patients with CSOM is more than cholesteatoma, but SNHL is more evidently seen in those who had cholesteatoma rather than granulation tissue or polyp. The present study notices that (15) patients with (9.375%) had severe SNHL (> 70 dB) which occurred with higher frequencies as shown in 4000 & 8000 Hz. CONCLUSION: Sensorineural hearing loss occurs as a result of CSOM, especially with long duration of disease & in attic TM perforation and with active disease & presence of pathology like polyp, granulation tissue or Choleasteama. PTA is required regularly for patients with CSOM and should not be ignored to detect SNHL as early as possible. Key words: Chronic suppurative otitis media, Sensorineural hearing loss, Cholesteatoma.