Introduction Diseases of the nose and paranasal sinuses are known to influence the middle ear conditions. In the evaluation of the patients with chronic otitis media, radiological, endoscopic, and other auxiliary diagnostic tools may have their roles in the objective assessment of the patients, and to rule out lesions of the nasal cavity and the nasopharynx as potential aetiological factors. Materials and method This cross sectional observational study was conducted for a period of two years to establish the role of sinusitis as focus of sepsis in patients with tubotympanic type of CSOM. All patients in the age group of 20-40 years with more than 2 months of ear discharge and with a hearing loss of 25- 40 db and  diagnosed as tubotympanic type of CSOM were included in our study. Patients who had features of mastoiditis on X-ray and also with persistent ear discharge even after treatment with oral and topical antibiotics were subjected (n=70) to diagnostic nasal endoscopy and computed tomography of paranasal sinuses.  Result Among the 100 patients of CSOM, 70% had features suggestive of sinusitis. Deviated nasal septum (40%) was the most common pathology among the study population. Majority (54%) of them had mucopurulent type of ear discharge. The CT findings of the paranasal sinuses revealed that 48.5% of the study population had grade I type of involvement of the PNS. 54.2% of the patients had a large central perforation and the middle ear mucosa was found to be edematous for 65.7% of the patients. Discussion Coexistence of deviated nasal septum and chronic rhinosinusitis with discharging CSOM is at par with several other studies conducted in other parts of the world. Conclusion Deviated nasal septum, enlarged middle turbinate, medialised uncinate associated with sinusitis are the predisposing factors in the development of CSOM.  So assessment for sinusitis in the treatment of CSOM should become a routine practice.