Complications of chronic suppurative otitis media and their management: five year study at tertiary care centre

Abstract

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media is a disease that can end up in complications when treatment is delayed. The present prospective study was conducted at our tertiary care hospital and teaching centre to evaluate the incidence of complications of CSOM and their management.</p><p class="abstract"><strong>Methods:</strong> We analysed the clinical and intra operative findings, type of medical and surgical management and recovery of the patient. </p><p class="abstract"><strong>Results:</strong> Total 20 cases of CSOM with complications were reviewed in study period of 5 years. Of these 20 cases, 14 cases had extracranial (EC) while 6 cases had intracranial (IC) complications. The encountered IC complications were brain abscess ie temporal lobe abscess, pyogenic meningitis, lateral sinus thrombophlebitis and extradural abscess. Among the EC complications, mastoid abscess, Bezolds abscess, zygomatic abscess and labyrinthitis were encountered. The IC complications presented with fever, headache, and signs of meningeal irritation. <em>Pseudomonas aeruginosa</em>, <em>Proteus</em>, <em>Staphylococcus epidermidis</em> and <em>E. coli</em> were the common organisms isolated. Both groups of patients had cholesteatoma and middle ear granulations. Surgery was the main modality of treatment with zero mortality rate. We reviewed the clinical presentation and management in both groups.</p><p class="abstract"><strong>Conclusions:</strong> CSOM complications, inspite of their reduced incidence still pose a great challenge in developing countries. When the disease presents late, it lead to difficulty in management and consequently higher mortality. Our study emphasizes the importance of early diagnosis and prompt management.</p>

Complications of chronic otitis media and their management: a study at tertiary care centre

“…This was in concordance with a study done by Basak et al where most of the patients were in the age group 21-30 years but in a study done by Mohite et al, most common age group was 35-55 years. 5,4 The male to female ratio was 1.27:1, which was similar to a study by Basak et al where the male: female ratio was 1.46. 5 It was also in concordance with to a study by Bento et al and Hussain et al 9,10…”

“…But life threatening complications are still seen to exist due to the changing virulence and susceptibility of bacteria, the state of individual patient and late presentation. 4 When water enters into ears or after an episode of upper respiratory tract infection, mostly patients present with painless otorrhoea, which resolves on medical management but recurrs again. So most of the cases suffer little due to discharge from ears, thereby delaying definitive management.…”

Intracranial and extracranial complications of chronic otitis media and their management at a tertiary care center: a descriptive study

“…In a study done by Mohite a total 20 cases of CSOM were identified with complications, out of which 14 patients (70%) had EC while 06(30%) patients had IC complications. 5 The common complication in their study, in EC group was subperiosteal abscess-10, followed by Bezolds abscess-1, zygomatic abscess-1 and labyrinthitis-2. The complications encountered in IC group were temporal lobe abscess-1, pyogenic meningitis-2, lateral sinus thrombophlebitis-2 and extradural abscess-1.…”