REVISITING KARNASRAVA: INTEGRATING AYURVEDIC CONCEPTS WITH MODERN OTOLOGICAL INSIGHTS

Karnasrava is an ear disorder described in Ayurvedic literature, primarily characterized by chronic ear discharge, whereas Chronic Suppurative Otitis Media (CSOM) is a well-defined otological condition involving persistent middle-ear infection with tympanic membrane perforation. Despite arising from distinct medical paradigms, both conditions exhibit notable similarities in etiology, pathogenesis, clinical features, and management principles. This review aims to interpret Karnasrava through the conceptual framework of CSOM to establish a meaningful correlation between the two entities. Classical Ayurvedic texts, including Sushruta Samhita and allied treatises, were critically analyzed alongside contemporary otological literature. Ayurvedic concepts such as Nidana Sevana, Avarana of Vata, Kapha involvement, and Sthana Sanshraya demonstrate close parallels with modern mechanisms including Eustachian tube dysfunction, chronic mucosal inflammation, persistent infection, and impaired middle ear ventilation. Clinical manifestations such as otorrhoea, pain, itching, and hearing impairment further support this correlation. Additionally, the concept of Putikarna, characterized by foul-smelling discharge, aligns with the clinical presentation of squamosal CSOM associated with cholesteatoma and necrotic changes. Therapeutic approaches in Ayurveda, including local procedures, show functional similarity to modern strategies focused on infection control, dry ear maintenance, and tissue healing. Thus, Karnasrava can be correlated with mucosal CSOM, while Putikarna corresponds to the squamosal type, supporting an integrative approach to disease understanding and management. Keywords: Karnasrava, CSOM, Chronic Suppurative Otitis Media, Karnaroga, Shalakya tantra, Mucosal and Squamosal CSOM, Putikarna, Tubo-tympanic CSOM, Attico-antral CSOM.