Complications of acute otitis media in children

Abstract

The clinical picture and the treatment of acute otitis media (AOM) and its complications have changed during the past decades. The availability of antibiotics has decreased the incidence of complications of AOM significantly. The treatment of complications of AOM is conservative in most cases. Mastoidectomy is needed when abscess-forming mastoiditis or intracranial complications develop. Although intratemporal and intracranial complications of AOM are rare today, they still cause morbidity, and need prompt treatment. Occasionally, permanent damage of the ear leads to hearing loss, vertigo, and sometimes, facial weakness. Antibiotic treatment has decreased the mortality associated with the complications of AOM, but it is still high in countries with developing health care systems. Early diagnosis and effective treatment of the complications are the bases for a good prognosis.

Late Relapses in Acute Promyelocytic Leukaemia

“…However, as patient No. 2 did not receive ATRA before ear involvement, different mechanisms other than ATRA should also be explored: a lower vascularization of the mastoid as compared to the middle ear has been reported and justifies the frequent occurrence of mastoiditis as a complication of otitis treatment [9] due to a suboptimal concentration of antibiotics. The same mechanism could be involved in APL late relapse, with an inadequate local drug concentration.…”

Otitis Media Complications

“…When the infection in the mastoid compromises the integrity of the cortical layer of the mastoid, a subperiosteal abscess (SA) results. The most frequent location is retroauricular, less frequent is a Bezold's abscess where the infection propagates to the tip of the mastoid and Citelli's abscess where the extension is towards the occipital region [11].…”

Outpatient antibiotic therapy as a predisposing factor for bacterial resistance: a rational approach to airway infections

“…Entre os pacientes com OMA, a importância da antibioticoterapia decorre das complicações e seqüelas que podem ser estabelecidas quando a etiologia é bacteriana, a exemplo de mastoidite e surdez de condução 47 49 demonstraram que a resolução espontânea da OMA pode acontecer e está na dependência do agente etiológico: 48% para H. influenzae e 18% para S. pneumoniae. Uma recente meta-análise de 63 estudos demonstrou que os sintomas da OMA melhoram em 24 h sem uso de antibióticos em 61% das crianças (IC95% 50-72%), aumentando para 80% em 2 a 3 dias (IC95% 69-90%).…”