Complications of chronic suppurative otitis media: challenge for a developing country

Year 2014, Volume: 24 Issue: 5, 265 - 270, 15.10.2014

Fazal I Wahid Adil Khan Iftikhar Ahmad Khan

Abstract

Objectives: This study aims to investigate the frequency and management of complications of chronic suppurative otitis media CSOM . Patients and Methods: Out of 376 patients with CSOM, 44 patients 25 males, 19 females; mean age 48.5±3.5 years; range 21 to 76 years meeting study criteria were enrolled in this descriptive cross sectional study which was conducted at the Department of Ear Nose and Throat, Head and Neck Surgery, Postgraduate Medical Institute, Lady Reading Hospital Peshawar. All newly diagnosed patients having CSOM with complications were enrolled. The complications were treated first. Intracranial abscesses were evacuated by neurosurgeons. Radical and modified radical mastoidectomy were performed. Results: Majority of the patients presented in the second and third decade of life 21-30 years: 27.27%, 31-40 years: 18.18% . Most of the patients 59.1% had lower socioeconomic status. Canal wall down mastoidectomy was the most common 79.5% procedure performed. Cholesteatoma was the most common operative finding 100% . Among extracranial complications, subperiosteal abscess was the most common finding 38.63% , while extradural abscess outnumbered 22.72% in intracranial complications. Conclusion: Complications of CSOM commonly affect younger people with low socioeconomic status. Collaborating with neurosurgeons may assist in the successful management of this infection.

Keywords

Extracranial complications, intracranial complications, suppurative otitis media

Süpüratif otitis media komplikasyonları: Gelişen bir ülke için zorluk

Abstract

Amaç: Bu çalışmada kronik süpüratif otitis media KSOM komplikasyonlarının sıklığı ve yönetimi araştırıldı.Hastalar ve Yöntemler: Lady Reading Hastanesi Peşaver, Lisansüstü Tıp Enstitüsü, Kulak Burun ve Boğaz, Baş ve Boyun Cerrahisi Bölümünde yapılan bu tanımlayıcı kesitsel çalışmaya KSOM’lu 376 hastadan çalışma kriterlerini karşılayan 44 hasta 25 erkek, 19 kadın; ort. yaş 48.5±3.5 yıl; dağılım 21-76 yıl dahil edildi. Tanısı yeni konulmuş KSOM’u ve komplikasyonları olan tüm hastalar dahil edildi. Önce komplikasyonlar tedavi edildi. İntrakraniyal apseler beyin cerrahları tarafından boşaltıldı. Radikal ve modifiye radikal mastoidektomi uygulandı.Bulgular: Hastaların çoğu yaşamlarının ikinci ve üçüncü on yılında başvurdu 21-30 yaş: %27.27, 31-40 yaş: %18.18 . Hastaların çoğunun sosyoekonomik durumu düşüktü %59.1 . Açık mastoidektomi en yaygın uygulanan işlemdi %79.5 . Kolesteatom en yaygın ameliyat bulgusuydu %100 . Ekstrakraniyal komplikasyonlar içinde subperiostal apse en yaygın bulgu iken %38.63 intrakraniyal komplikasyonlarda ekstradural apse daha çoktu %22.72 .Sonuç: Kronik süpüratif otitis media komplikasyonları yaygın olarak düşük sosyoekonomik durumu olan daha genç insanları etkiler. Beyin cerrahlarıyla işbirliği yapılması bu enfeksiyonun başarıyla yönetilmesinde yardımcı olabilir

Keywords

Ekstrakraniyal komplikasyonlar, intrakraniyal komplikasyonlar, süpüratif otitis media

References

• Aldakhail AA. Chronic suppurative otitis media with intracranial complication. Neurosciences 2006;11:322-5.
• Lin YS, Lin LC, Lee FP and Lee KJ. The prevalence of chronic otitis media and its complication rates in teenagers and adult patients. Otolaryngol-Head Neck Surg 2009;140:165-70.
• Singh M, Jain S, Rajput R, Khatua RK, Sharma D. Retrospective and prospective study of Singapore swing method on healing of mastoid cavity. Indian J Otolaryngol Head Neck Surg 2010;62:365-71.
• Lasisi AO, Olaniyan FA, Muibi SA, Azeez IA, Abdulwasiu KG, Lasisi TJ, et al. Clinical and demographic risk factors associated with chronic suppurative otitis media. Int J Paediatr Otorhinolaryngol 2007;71:1549-54.
• O’Connor TE, Perry CF, Lannigan FJ. Complications of otitis media in Indigenous and non-Indigenous children. Med J Aust 2009;191:60-4.
• Skotnicka B. Complications of otitis media in children in the era of antibioticotherapy. Otolaryngol Pol 2007;61:779-83.
• Yorgancılar E, Yildirim M, Gun R, Bakir S, Tekin R, Gocmez C, et al. Complications of chronic suppurative otitis media: a retrospective review. Eur Arch Otorhinolaryngol 2013;270:69-76.
• Hossain MM, Kundu SC, Haque MR, Shamsuzzaman AK, Khan MK, Halder KK. Extracranial complications of chronic suppurative otitis media. Mymensingh Med J 2006;15:4-9.
• Wu JF, Jin Z, Yang JM, Liu YH, Duan M. Extracranial and intracranial complications of otitis media: 22-year clinical experience and analysis. Acta Otolaryngol 2012;132:261-5.
• Morris PS, Richmond P, Lehmann D, Leach AJ, Gunasekera H, Coates HL. New horizons: otitis media research in Australia. Med J Aust 2009;191:S73-7.
• Baig MM, Ajmal M, Saeed I, Fatima S. Prevalence of cholesteatoma and its complications in patients of chronic suppurative otitis media. J Rawalpindi Med Coll 2011;15:16-17.
• Memon MA, Thaheem K, Marfani MS. Frequency and complications of cholesteatoma in cases of chronic suppurative otitis media. Pak J Otolaryngol 2005;21:48-9.
• Yagizy R, Adali MK, Abdullah TAS, Uzun C, Koten M, Karasalihoglu A. Intracranial complications of chronic suppurative otitis media. Trakya Univ Tip Fak Derg 2008;25:196-203.
• Vikram BK, Khaja N, Udayashankar SG. Clinico- epidemiological study of complicated and uncomplicated chronic suppurative otitis media. J Laryngol Otol 2008;122:442-6.
• Islam MR, Taous A, Hossain MM, Ekramuddaula AFM, Islam MS. Comparative study of tubotympanic and atticoantral variety of Chronic suppurative otitis media. Bangladesh J Otorhinolaryngol 2010;16:113-9.
• Magsi PB, Jamro B, Sangi HA. Clinical presentation and outcome of mastoidectomy in chronic suppurative otitis media (CSOM) at tertiary care hospital, Sukkur, Pakistan. Rawal Med J 2012;37:50-3.
• Matanda RN, Muyunga KC, Sabue MJ, Creten W, Van de Heyning P. Chronic suppurative otitis media and related complications at the University Clinic of Kinshasa. B-ENT 2005;1:57-62.
• Ceylan A, Bayazit Y, Yilmaz M, Celenk F, Bayramoglu I, Uygur K, et al. Extracranial complications of chronic otitis media. Int Adv Otol 2009;5:51-5.
• Khan A, Khan MI, Muhammad. Intracranial complications of chronic suppurative otitis media: clinical presentation and outcome of surgical procedures. Gomal J Med Sci 2012;10:186-9.
• Sengupta A, Anwar T, Ghosh D, Basak B. A study of surgical management of chronic suppurative otitis media with cholesteatoma and its outcome. Indian J Otolaryngol Head Neck Surg 2010;62:171-6.
• Miranda HA, Leones SMC, Elzain MA, Salazar LRM. Brain abscess: Current management. J Neurosci Rural Pract 2013;4:67-81.
• Gadgil N, Patel AJ, Gopinath SP. Open craniotomy for brain abscess: A forgotten experience? Surg Neurol Int 2013;4:34.
• Dubey SP, Larawin V. Complications of chronic suppurative otitis media and their management. The Laryngoscope 2007;117:264-7.
• Adoga A, Nimkur T, Silas O. Chronic suppurative otitis media: Socio-economic implications in a tertiary hospital in Northern Nigeria. Pan Afr Med J 2010;4:3.
• 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.