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

Abstract

Objective: 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 challenge. A careful history, physical examination, effective use of imaging technology and most importantly, a greater awareness of COM complications will reduce their morbidity and mortality.

Keywords

• Otitis media, suppurative, complications, cholesteatoma

Kronik otitis media komplikasyonları: 1293 olgunun retrospektif analizi

Öz

Amaç: Kronik otitis medianın klinik bulgu ve semptomlarının, tanı ve tedavi sonuçları ile birlikte dağılım ve insidansının değerlendirilmesi amaçlanmıştır. Yöntem: Bu çalışmada kronik otitis media tanısı konulan 1293 hasta içerisinde komplikasyon saptanan 39 hastanın klinik ve operatif bulguları retrospektif olarak incelendi. Uygulanan cerrahi teknik, komplikasyonların insidansı ve yönetimi, hastaların morbiditesi ve mortalitesi ilgili literatür ile karşılaştırıldı. Bulgular: Olguların %58.9'u (n=23) erkek ve %41.1'i (n=16) kadındır. Olguların 8'i (%20.5) intrakraniyal komplikasyon ve 31'i (%79.5) ise ekstrakraniyal komplikasyon idi. İntrakraniyal komplikasyonlardan lateral sinüs trombozu (%50), ekstrakraniyal komplikasyonlardan ise labirent fistülü (%64.5) en sık komplikasyon olarak tespit edildi. Komplikasyon gelişen hastalardaki en sık semptomlar otore, işitme kaybı ve baş dönmesi idi. Komplikasyonu olan 39 hastanın 27'sine (%69.2) radikal mastoidektomi, bu hastalarında 2'sine eş zamanlı olarak labirentektomi yapılmıştır. Sırasıyla bir (%2.5) hastaya revizyon radikal mastoidektomi, 6 (%15.5) hastaya kanal wall down timpanomastoidektomi, 5 (%12.8) hastaya da kanal wall up timpanomastoidektomi yapılmıştır. Tüm hastalar iyileşmiş ve ortalama 46±22 aylık takip süresinde mortalite oranı %0'dır. Sonuç: Otojen komplikasyonlar, günümüzde azalmasına rağmen yaşamı tehdit etmeye devam etmektedirler. Dikkatli bir anamnez, fizik muayene, görüntüleme yöntemlerinin etkin kullanımı ve en önemlisi komplikasyondan şüphelenmek komplikasyonlara bağlı morbidite ve mortaliteyi azaltacaktır.

Anahtar Kelimeler

• Otitis media, süpüratif, komplikasyonlar, kolestatom

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24. Please cite this article as: Karakafl M, Balıkçı HH, Özkul MH, Çelebi Ş, Bayram Ö, Bayram AA. Complications of chronic otitis media: a retrospec
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