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

Year 2014, Volume: 4 Issue: 2, 43 - 48, 01.06.2014
https://doi.org/10.2399/jmu.2014002003

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.

References

  • Dubey SP, Larawin V, Molumi CP. Intracranial spread of chron- ic middle ear suppuration. Am J Otolaryngol 2010;31:73-7.
  • Seven H, Coskun BU, Calis AB, Sayin I, Turgut S. Intracranial abscesses associated with chronic suppurative otitis media. Eur Arch Otorhinolaryngol 2005;262:847-51.
  • Osma U, Cureoglu S, Hosoglu S. The complications of chronic otitis media. J Laryngol Otol 2000;114:97-100.
  • Gower D, McGuirt WF. Intracranial complications of acute and chronic infectious ear disease: a problem still wit us. Laryngoscope 1983;93:1028-33.
  • Rupa V, Raman R. Chronic suppurative otitis media: complicat- ed versus uncomplicated deisease. Acta Otolaryngol 1991;111: 530-5.
  • Dubey SP, Larawin V. Complications of chronic suppurative oti- tis media and their management. Laryngoscope 2007;117:264-7.
  • Kangsanarak J, Fooanant S, Ruckphaopunt K, Navacharoen N, Teotrakul S. Extracranial and intracranial complications of sup- purative otitis media. Report of 102 cases. J Laryngol Otol 1993; 107:999-1004.
  • Samuel J, Fernandes CM, Steinberg JL. Intracranial otogenic complications: a persisting problem. Laryngoscope 1986;96:272-8.
  • Gersdorff MC, Nouwen J, Decat M, Degol JC, Bosch P. Labryinthine fistula after cholesteatomatous chronic otitis media. Am J Otol 2000;21:32-5.
  • Bhat V, Manjunath D. Cerebrospinal fluid otorrhea presenting in complicated chronic suppurative otitis media. Ear Nose Throat J 2007;86:223-5.
  • Kangsanarak J, Navacharoen N, Foonant S, Ruckphaopunt K. Intracranial complications of suppurative otitis media: 13 years’ experience.. Am J Otol 1995;16:104-9.
  • Viswanatha B, Naseeruddin K. Lateral sinus thrombosis in otol- ogy: a review. Mediterr J Hematol Infect Dis 2010;2(3):e2010027.
  • Mostafa BE, El Fiky LM, El Sharnouby MM. Complications of suppurative otitis media: still a problem in the 21st century. ORL J Otorhinolaryngol Relat Spec 2009;71:87-92.
  • Samuel J, Fernandes CM. Lateral sinus thrombosis (a review of 45 cases). J Laryngol Otol 1987;101:1227-9.
  • Ooi EH, Hilton M, Hunter G. Management of lateral sinus thrombosis: update and literature review. J Laryngol Otol 2003; 117:932-9.
  • Shah UK, Jubelirer TF, Fish JD, Elden LM. A caution regarding the use of low-molecular weight heparin in pediatric otogenic lat- eral sinus thrombosis. Int J Pediatr Otorhinolaryngol 2007;71: 347-51.
  • Kuczkowski J, Mikaszewski B. Intracranial complications of acute and chronic mastoiditis: report of two cases in children. Int J Pediatr Otorhinolaryngol 2001;60:227-37.
  • Lee JH, Choi SJ, Park K, Choung YH. Managements for lateral sinus thrombosis: does it need the ligation of internal jugular vein or anticoagulants? Eur Arch Otorhinolaryngol 2009;266: 51-8.
  • Bradley DT, Hashisaki GT, Mason JC. Otogenic sigmoid sinus thrombosis: what is the role of anticoagulation? Laryngoscope 2002;112:1726-9.
  • Singh B, Maharaj TJ. Radical mastoidectomy. J Laryngol Otol 1993;107:1113-8.
  • This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported (CC BY
  • NC-ND0) Licence (http://creativecommons.org/licenses/by-nc-nd/3.0/) which permits unrestricted noncommercial use, distribution, and reproduc
  • tion in any medium, provided the original work is properly cited.
  • Please cite this article as: Karakafl M, Balıkçı HH, Özkul MH, Çelebi Ş, Bayram Ö, Bayram AA. Complications of chronic otitis media: a retrospec
  • tive analysis of 1293 cases. J Med Updates 2014;4(2):43-48.

Kronik otitis media komplikasyonları: 1293 olgunun retrospektif analizi

Year 2014, Volume: 4 Issue: 2, 43 - 48, 01.06.2014
https://doi.org/10.2399/jmu.2014002003

Abstract

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.

References

  • Dubey SP, Larawin V, Molumi CP. Intracranial spread of chron- ic middle ear suppuration. Am J Otolaryngol 2010;31:73-7.
  • Seven H, Coskun BU, Calis AB, Sayin I, Turgut S. Intracranial abscesses associated with chronic suppurative otitis media. Eur Arch Otorhinolaryngol 2005;262:847-51.
  • Osma U, Cureoglu S, Hosoglu S. The complications of chronic otitis media. J Laryngol Otol 2000;114:97-100.
  • Gower D, McGuirt WF. Intracranial complications of acute and chronic infectious ear disease: a problem still wit us. Laryngoscope 1983;93:1028-33.
  • Rupa V, Raman R. Chronic suppurative otitis media: complicat- ed versus uncomplicated deisease. Acta Otolaryngol 1991;111: 530-5.
  • Dubey SP, Larawin V. Complications of chronic suppurative oti- tis media and their management. Laryngoscope 2007;117:264-7.
  • Kangsanarak J, Fooanant S, Ruckphaopunt K, Navacharoen N, Teotrakul S. Extracranial and intracranial complications of sup- purative otitis media. Report of 102 cases. J Laryngol Otol 1993; 107:999-1004.
  • Samuel J, Fernandes CM, Steinberg JL. Intracranial otogenic complications: a persisting problem. Laryngoscope 1986;96:272-8.
  • Gersdorff MC, Nouwen J, Decat M, Degol JC, Bosch P. Labryinthine fistula after cholesteatomatous chronic otitis media. Am J Otol 2000;21:32-5.
  • Bhat V, Manjunath D. Cerebrospinal fluid otorrhea presenting in complicated chronic suppurative otitis media. Ear Nose Throat J 2007;86:223-5.
  • Kangsanarak J, Navacharoen N, Foonant S, Ruckphaopunt K. Intracranial complications of suppurative otitis media: 13 years’ experience.. Am J Otol 1995;16:104-9.
  • Viswanatha B, Naseeruddin K. Lateral sinus thrombosis in otol- ogy: a review. Mediterr J Hematol Infect Dis 2010;2(3):e2010027.
  • Mostafa BE, El Fiky LM, El Sharnouby MM. Complications of suppurative otitis media: still a problem in the 21st century. ORL J Otorhinolaryngol Relat Spec 2009;71:87-92.
  • Samuel J, Fernandes CM. Lateral sinus thrombosis (a review of 45 cases). J Laryngol Otol 1987;101:1227-9.
  • Ooi EH, Hilton M, Hunter G. Management of lateral sinus thrombosis: update and literature review. J Laryngol Otol 2003; 117:932-9.
  • Shah UK, Jubelirer TF, Fish JD, Elden LM. A caution regarding the use of low-molecular weight heparin in pediatric otogenic lat- eral sinus thrombosis. Int J Pediatr Otorhinolaryngol 2007;71: 347-51.
  • Kuczkowski J, Mikaszewski B. Intracranial complications of acute and chronic mastoiditis: report of two cases in children. Int J Pediatr Otorhinolaryngol 2001;60:227-37.
  • Lee JH, Choi SJ, Park K, Choung YH. Managements for lateral sinus thrombosis: does it need the ligation of internal jugular vein or anticoagulants? Eur Arch Otorhinolaryngol 2009;266: 51-8.
  • Bradley DT, Hashisaki GT, Mason JC. Otogenic sigmoid sinus thrombosis: what is the role of anticoagulation? Laryngoscope 2002;112:1726-9.
  • Singh B, Maharaj TJ. Radical mastoidectomy. J Laryngol Otol 1993;107:1113-8.
  • This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported (CC BY
  • NC-ND0) Licence (http://creativecommons.org/licenses/by-nc-nd/3.0/) which permits unrestricted noncommercial use, distribution, and reproduc
  • tion in any medium, provided the original work is properly cited.
  • Please cite this article as: Karakafl M, Balıkçı HH, Özkul MH, Çelebi Ş, Bayram Ö, Bayram AA. Complications of chronic otitis media: a retrospec
  • tive analysis of 1293 cases. J Med Updates 2014;4(2):43-48.
There are 25 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Mustafa Karakaş This is me

H. Hüseyin Balıkçı This is me

M. Haluk Özkul This is me

Şaban Çelebi This is me

Özlem Bayram This is me

A. Alper Bayram This is me

Publication Date June 1, 2014
Published in Issue Year 2014 Volume: 4 Issue: 2

Cite

APA Karakaş, M., Balıkçı, H. H., Özkul, M. H., Çelebi, Ş., et al. (2014). Kronik otitis media komplikasyonları: 1293 olgunun retrospektif analizi. Journal of Medical Updates, 4(2), 43-48. https://doi.org/10.2399/jmu.2014002003
AMA Karakaş M, Balıkçı HH, Özkul MH, Çelebi Ş, Bayram Ö, Bayram AA. Kronik otitis media komplikasyonları: 1293 olgunun retrospektif analizi. Journal of Medical Updates. June 2014;4(2):43-48. doi:10.2399/jmu.2014002003
Chicago Karakaş, Mustafa, H. Hüseyin Balıkçı, M. Haluk Özkul, Şaban Çelebi, Özlem Bayram, and A. Alper Bayram. “Kronik Otitis Media komplikasyonları: 1293 Olgunun Retrospektif Analizi”. Journal of Medical Updates 4, no. 2 (June 2014): 43-48. https://doi.org/10.2399/jmu.2014002003.
EndNote Karakaş M, Balıkçı HH, Özkul MH, Çelebi Ş, Bayram Ö, Bayram AA (June 1, 2014) Kronik otitis media komplikasyonları: 1293 olgunun retrospektif analizi. Journal of Medical Updates 4 2 43–48.
IEEE M. Karakaş, H. H. Balıkçı, M. H. Özkul, Ş. Çelebi, Ö. Bayram, and A. A. Bayram, “Kronik otitis media komplikasyonları: 1293 olgunun retrospektif analizi”, Journal of Medical Updates, vol. 4, no. 2, pp. 43–48, 2014, doi: 10.2399/jmu.2014002003.
ISNAD Karakaş, Mustafa et al. “Kronik Otitis Media komplikasyonları: 1293 Olgunun Retrospektif Analizi”. Journal of Medical Updates 4/2 (June 2014), 43-48. https://doi.org/10.2399/jmu.2014002003.
JAMA Karakaş M, Balıkçı HH, Özkul MH, Çelebi Ş, Bayram Ö, Bayram AA. Kronik otitis media komplikasyonları: 1293 olgunun retrospektif analizi. Journal of Medical Updates. 2014;4:43–48.
MLA Karakaş, Mustafa et al. “Kronik Otitis Media komplikasyonları: 1293 Olgunun Retrospektif Analizi”. Journal of Medical Updates, vol. 4, no. 2, 2014, pp. 43-48, doi:10.2399/jmu.2014002003.
Vancouver Karakaş M, Balıkçı HH, Özkul MH, Çelebi Ş, Bayram Ö, Bayram AA. Kronik otitis media komplikasyonları: 1293 olgunun retrospektif analizi. Journal of Medical Updates. 2014;4(2):43-8.