The diagnosis of the disease requires identification of several types of chronic suppurative otitis media, simple, osteosclerotic, and cholesteatoma types. (a) Simple type: Papillary radiographs are often sclerotic without osteochondral destruction. (b) Bone ulcer type: papillary radiographs are sclerotic or laminar type with bone defect destruction. (c) Cholesteatoma type: Papillary radiographs show areas of bone destruction in the superior tympanic chamber, tympanic sinus or mastoid process with dense, neat margins. In the acute stage, otoscopy and pus cleaning are required. Hearing examination is usually required after the inflammation is controlled, and CT examination of the middle ear is required in suspected cases of cholesteatoma or osteomalacia type otitis media.