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

Abstract

Background: 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.

Methods: We analysed the clinical and intra operative findings, type of medical and surgical management and recovery of the patient.  

Results: 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. Pseudomonas aeruginosa, Proteus, Staphylococcus epidermidis and E. coli 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.

Conclusions: 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.