Zuska's disease is also known as chronic suppurative otitis media (CSOM) with labyrinthine fistula, which is a rare complication of chronic otitis media, an infection of the middle ear that persists for a long time.

Overview:

Zuska's disease is characterized by formation of an abnormal passage from the middle ear to the inner ear through a hole in the latter due to chronic infections and inflammation. When this happens, it may cause more serious problems such as hearing loss, vestibular dysfunction and even meningitis if surrounding structures are infected.

Symptoms:

Symptoms of Zuska's disease can include:

• Hearing Loss: Can range from mild to severe depending on how much inner ear is affected.
• Vertigo: This sensation results from malfunctions in the vestibular system that causes spinning or dizziness when individuals change their body positions or move their heads quickly.
• Tinnitus: Ringing or buzzing sound in ears.
• Ear Discharge: Continuous or repeated secretions from the ear.
• Facial Weakness: In some cases when facial nerve is involved severely.

Epidemiology:

Zuska's disease is rare and occurs because of complications related to recurrent otitis media. It affects persons of any age group but is commonly seen among those who have had frequent or untreated middle ear infections previously.

Causes:

The primary cause of Zuska's disease is chronic otitis media, characterized by persistent inflammation and infection of the middle ear. Factors contributing to chronic otitis media include:

• Untreated or Recurrent Infections: Failure to adequately treat acute otitis media or recurrent ear infections.
• Poor Eustachian Tube Function: Dysfunction of the Eustachian tube, which normally helps ventilate and drain the middle ear.
• Underlying Conditions: Conditions such as immunodeficiency or anatomical abnormalities may predispose individuals to chronic otitis media.

Diagnosis:

Diagnosis of Zuska's disease involves:

• Clinical Evaluation: Including medical history and physical examination of the ear.
• Imaging Studies: CT scan or MRI to visualize the extent of middle ear and inner ear involvement.
• Hearing Tests: Audiometry to assess hearing loss.

Treatment:

Treatment of Zuska's disease may involve:

• Antibiotics: To treat active infections and prevent further spread.
• Surgical Repair: In severe cases, surgical closure of the labyrinthine fistula may be necessary to prevent complications.
• Hearing Aids: To manage hearing loss resulting from inner ear damage.
• Vestibular Rehabilitation: Exercises to improve balance and reduce vertigo.

Prevention:

Prevention of Zuska's disease involves:

• Prompt Treatment: Early diagnosis and treatment of acute otitis media to prevent progression to chronic otitis media.
• Good Ear Hygiene: Avoiding exposure to water or trauma that can exacerbate middle ear infections.
• Addressing Underlying Conditions: Treating underlying factors such as immune deficiencies or Eustachian tube dysfunction.

Conclusion:

Zuska's disease is a rare but serious complication of chronic otitis media. Prompt diagnosis, appropriate treatment, and preventive measures are essential for minimizing complications and preserving hearing and vestibular function. Individuals experiencing symptoms of chronic ear infections or hearing loss should seek medical attention for evaluation and management.