Complications of chronic otitis media: a retrospective analysis of 1293 cases

Abstract

Complications of chronic otitis media (COM) occur when the ear infection spreads to structures outside the middle ear mucosa, and the air spaces of the temporal bone. The spread of infection can occur via preformed pathways, bone Yöntem: Bu çal›flmada kronik otitis media tan›s› konulan 1293 hasta içerisinde komplikasyon saptanan 39 hastan›n klinik ve operatif bulgular› retrospektif olarak incelendi. Uygulanan cerrahi teknik, komplikasyonlar›n insidans› ve yönetimi, hastalar›n morbiditesi ve mortalitesi ilgili literatür ile karfl›laflt›r›ld›. Bulgular: Olgular›n %58.9'u (n=23) erkek ve %41.1'i (n=16) kad›nd›r. Olgular›n 8'i (%20.5) intrakraniyal komplikasyon ve 31'i (%79.5) ise ekstrakraniyal komplikasyon idi. ‹ntrakraniyal komplikasyonlardan lateral sinüs trombozu (%50), ekstrakraniyal komplikasyonlardan ise labirent fistülü (%64.5) en s›k komplikasyon olarak tespit edildi. Komplikasyon geliflen hastalardaki en s›k semptomlar otore, iflitme kayb› ve bafl dönme-si idi. Komplikasyonu olan 39 hastan›n 27'sine (%69.2) radikal mastoidektomi, bu hastalar›nda 2'sine efl zamanl› olarak labirentektomi yap›l-m›flt›r. S›ras›yla bir (%2.5) hastaya revizyon radikal mastoidektomi, 6 (%15.5) hastaya kanal wall down timpanomastoidektomi, 5 (%12.8) hastaya da kanal wall up timpanomastoidektomi yap›lm›flt›r. Tüm hastalar iyileflmifl ve ortalama 46±22 ayl›k takip süresinde mortalite oran› %0'd›r. Sonuç:Otojen komplikasyonlar, günümüzde azalmas›na ra¤men yaflam› tehdit etmeye devam etmektedirler. Dikkatli bir anamnez, fizik muayene, görüntüleme yöntemlerinin etkin kullan›m› ve en önemlisi komplikasyondan flüphelenmek komplikasyonlara ba¤l› morbidite ve mortaliteyi azaltacakt›r.Anahtar sözcükler: Otitis media, süpüratif, komplikasyonlar, kolestatom. AbstractObjective: To evaluate the clinical signs and symptoms, diagnosis, treatments, outcomes, distribution and incidence of the complications of chronic otitis media (COM). Methods:This retrospective study analyzed the clinical and operative findings of 1293 patients with COM, including 39 patients with complications of COM. We compared the surgical techniques, incidence and management of complications and morbidity and mortality rates with those reported in the relevant literature.Results: Of the patients with complications, 23 were male and 16 were female. Eight patients (20.5%) had intracranial complications, while 31 (79.5%) had extracranial complications. Lateral sinus thrombophlebitis and labyrinthine fistula were the most common intra-and extracranial complication, respectively. Of the 39 patients with complications, 27 underwent radical mastoidectomy, including two patients who underwent simultaneous labyrinthectomy. Revision radical mastoidectomy, canal wall down tympanomastoidectomy and canal wall up tympanomastoidectomy were performed in one, six and five patients, respectively. All patients did well, and the mortality rate was 0% during a follow-up period of 46±22 months. Conclusion:Despite their reduced incidence, COM complications continue to pose a great, clinical chall...

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