In chronic suppurative otitis media without cholesteatoma, which structure is mainly affected?

In chronic suppurative otitis media without cholesteatoma, the pars tensa is primarily affected. The pars tensa is the lower, larger part of the tympanic membrane (eardrum) and is crucial for its structural integrity and function. In this type of otitis media, the infection and inflammation can lead to perforations or retraction of the pars tensa, resulting in associated symptoms such as hearing loss and discharge.

Chronic suppurative otitis media typically affects the middle ear and often arises from Eustachian tube dysfunction, leading to poor ventilation and drainage. However, in the absence of cholesteatoma, the pathology is usually localized to the pars tensa, which can become compromised due to persistent fluid, infection, and inflammation.

While the other structures listed may play a role in the overall condition of the middle ear, they are not primarily affected in chronic suppurative otitis media without cholesteatoma. For instance, the pars flaccida is often associated with cholesteatoma formation and is less involved in this specific condition. The stapes, being part of the ossicular chain, may become affected indirectly due to the surrounding inflammatory process, but it is not the primary structure involved