Chronic suppurative otitis media is an inflammatory condition of middle ear and mastoid mucosa associated with bacterial biofilm commonly encountered in children. It is characterized by cholesteatoma, distortion of ossicular chains and conductive hearing loss. In the present study, we perform a systematic review of the literature with the purpose of identifying and discussing the treatment options emerged over the last 20 years in order to treat chronic suppurative otitis media. (n=336) studies were reviewed in total and (n=29) qualitative studies were included in this systematic review. 11 studies included depicted the efficacy of antibiotics, antiseptic solutions and 5 studies were on traditional herbal medicines, whereas 3 studies depicted about efficacy of vaccines, 7 studies were on nanoparticles and novel controlled drug delivery systems; and 3 studies depicted the efficacy of surgical approaches in CSOM. This systematic review of the literature draw definite conclusion that, auricularum powder, povidone-iodine based antiseptic solution, otikon otic solution, modified radical mastoidectomy, LAIV, and cip-P407-PBP improved otological condition by 51-87%, thus can be considered most suitable treatments for CSOM. This review provides a comprehensive discussion of the utility of diverse therapeutic remedies in modulation of otological symptoms, hearing threshold and bacterial colony counts involved in the pathogenesis of chronic suppurative otitis media.

Keywords : Otitis media; Ciprofloxacin; Otikon otic solution; Modified radical mastoidectomy; Live attenuated influenza vaccine