Complications of Chronic Suppurative Otitis Media and Their Management: A Single Institution 12 Years Experience

Abstract

To determine the incidence of otogenic complications of Chronic suppurative otitis media (CSOM) and its management. The study was conducted at the tertiary referral centre and teaching hospital. An analysis was made about the clinical and operative findings, surgical techniques and approaches, the overall management and recovery of the patient. The data were then compared with the relevant and available literature. Over the study period of 12 years, a total 45 cases of CSOM with complications were reviewed. Out of these 45 cases, 20 cases had extracranial (EC) while 25 cases had intracranial (IC) complications. The prevalence of each complication was 0.17 and 0.13 %, IC and EC respectively. The commonly encountered IC complications were brain abscess, meningitis and lateral sinus thrombophlebitis. Among the EC complications, mastoid abscess followed by labyrinthitis and facial nerve palsy were encountered. The reliable warning signs and symptoms of IC complications were fever, headache, earache vestibular symptoms, meningeal signs and impairment of consciousness. Proteus mirabilis, Pseudomonas aeruginosa, Staphylococcus epidermidis were the common organism isolated. Cholesteatoma and granulation in the middle ear were the major findings in both groups of cases. Surgery was main modality of management of these conditions. We observed that two patients fail to regain full facial nerve function despite of surgery. Mortality rate was zero but morbidity was seen in 15 % (3) and 28 % (7) of cases in EC and IC group respectively. The epidemiological presentation, clinical features and results of treatment are discussed. CSOM complications, despite its reduced incidence still pose a great challenge in developing countries, as the disease present in the advanced stage leading to difficulty in management and consequently higher morbidity. In this study we emphasize the importance of the accurate and early diagnosis followed by adequate surgical therapy with multidisciplinary approach.

Cerebellar Abscess as a Serious and Uncommon Complication of Chronic Otitis Media

“…tarafından yapılan çalışmalarda en sık görülen intrakraniyal komplikasyondur. 3 Ancak, Miura ve ark. ile Kurien ve ark.…”

“…4,5 Otojen intrakraniyal apseler, en çok temporal lobda ve serebellumda görülmekle birlikte, daha az sıklıkla parietal ve oksipital loblarda da gelişebilmektedir. 3,6 Ancak, Mary Kurien ve ark.nın yaptığı çalışmada, otojen beyin apselerinin en sık serebellumda görüldüğü, temporal apse ve subdural ampiyemin göreceli olarak daha az görüldüğü bildirilmiştir. 5 Olgumuzda da Mary Kurien ve ark.nın çalışması ile uyumlu olarak serebellumda sınırlı bir apse oluşumu vardı.…”

Otitis Media Supuratif Kronis Tipe Kolesteatom dengan Komplikasi Meningitis dan Paresis Nervus Fasialis Perifer

“…4,5 Keterlambatan diagnosis dan penatalaksanaan berakibat munculnya komplikasi yang dapat meningkatkan angka kematian. 2,4,6 Komplikasi dapat terjadi karena adanya infeksi, inflamasi, jaringan granulasi dan pembentukan kolesteatom yang terus menerus. 5 Komplikasi OMSK ini terdiri dari komplikasi intrakranial dan intratemporal (ekstrakranial).…”

“…5 Komplikasi OMSK ini terdiri dari komplikasi intrakranial dan intratemporal (ekstrakranial). 1,6,7 Mikroorganisme juga berperan besar dalam kejadian OMSK, baik bakteri aerob maupun anaerob. Penyebab terbanyak adalah Pseudomonas aeruginosa, Klebsiella, Staphylococcus aureus, Proteus mirabilis.…”

“…Penyebab terbanyak adalah Pseudomonas aeruginosa, Klebsiella, Staphylococcus aureus, Proteus mirabilis. 1,6,8 Dalam hal ini, perkembangan antibiotik turut berperan dalam menekan angka kejadian OMSK. 1,6 Anatomi Telinga…”