Published: 2020-01-24

A study of complications of chronic suppurative otitis media at tertiary care hospital

Bhagirathsinh D. Parmar, Sushil Jha, Vikas Sinha, Nirav Chaudhury, Gavendra Dave


Background: Chronic suppurative otitis media (CSOM) is a still common disease in developing country and is found sometimes difficult to treat. Different complications can develop inspite of availability of higher antibiotics. In pre-antibiotic era, complications of acute otitis media and CSOM were very common and lead to high mortality. Inspite of initial decline in the complication of CSOM due to higher antibiotics, the incidences are still on rise. CSOM remains a serious disease, particularly in developing countries and CSOM-related complications are still found life-threatening. The aim and objective was to study various clinical presentations and management of CSOM related complications.

Methods: All patients of chronic supurrative otitis media with intra or extracranial complication who were admitted in Department of Otorhinolaryngology Head and Neck surgery, Sir. T. General Hospital, Government Medical College, Bhavnagar from July 2015 to December 2018 was included in this study. Data of clinical presentation, associated complication, management, and follow-up were analysed.  

Results: Out of 250 patients of CSOM admitted during these 3 years in ENT Department, 36 patients presented with CSOM related complications. 15 patients presented with intracranial complications and 21 patients presented with extracranial complications.

Conclusions: Inspite of availability of higher antibiotics, CSOM related complications are still common. In all the patients require higher intravenous antibiotics (which crosses blood brain barrier) followed by mastoid surgeries.


CSOM, High resolution computed tomography scan, Acute otitis media

Full Text:



Gandhi B, Agrawal A. Clinical profile of patients with complications fillowing otitis media. Indian J Otolaryngol Head Neck Surg. 2001;53:11-3.

Midak V, Chavan V, Borade V, et al. Intracranial complications of otitis media: in retrospect. Indian J Otolaryngol Head Neck Surg. 2005;57:130-5.

Bansal M. Disease of Ear Nose and Throat- Mohan Bansal, 1st edition. Jaypee; 2013: 216-226.

YorgancÂlar M, YÂldÂrÂm R, Gun S, BakÂr R, TekÂn C, Gocmez F, et al. Complications of chronic suppurative otitis media: a retrospective review. Eur Arch Otorhinolaryngol. 2013;270:69–76.

Neeta S, Ashwin J, Praveer B, Amrish G. Complications of Chronic Suppurative Otitis Media and Their Management: A Single Institution 12 Years Experience. Indian J Otolaryngol Head Neck Surg. 2015;67:353-60.

Dubey S, Larawin V. Complications of chronic suppurative otitis media and their management. Laryngoscope. 2007;117:264-7.

Kangsanarak J, Fooanant S, Ruckphaopunt K, Navacharoen N, Teotrakul S. Extracranial and intracranial complications of suppurative otitis media: report of 102 cases. J Laryngol Otol. 1993;107:999-1004.

Mostafa B, El Fiky M, El Sharnouby M. Complications of suppurative otitis media: still a problem in the 21st century. ORL J Otorhinolaryngol Relat Spec. 2009;71(2):87-92.

Dubey P, Larawin V, Molumi P. Intracranial spread of chronic middle ear suppuration. Am J Otolaryngol. 2010;31(2):73-7.

Osma U, Cureoglu S, Hosoglu S. The complications of chronic otitis media: report of 93 cases. J Laryngol Otol. 2000;114:97-100.

Sennaroglu L, Sozeri B. Otogenic brain abscess: review of 41 cases. Otolaryngol Head Neck Surg. 2000;123:751-5.

Seven H, Coskun U, Calis B, Sayin I, Turgut S. Intracranial abscesses associated with chronic suppurative otitis media. Eur Arch Otorhinolaryngol. 2005;262(10):847-51.

Gleeson M. Scott and Browns 7th edition pages. Volume 3. Hodder Arnold Publication; 2008: 3395-3445.

Singh B, Maharaj J. Radical mastoidectomy: its place in otitic intracranial complications. J Laryngol Otol. 1993;107:1113-8.

Samuel J, Fernandes M. Lateral sinus thrombosis (review of 45 cases). J Laryngol Otol. 1987;101(12):1227-9.

Kangsanarak J, Navacharoen N, Fooanant S, Ruckphaopunt K. Intracranial complications of suppurative otitis media: 13 years’ experience. Am J Otol. 1995;16(1):104-9.

Mustafa A, Heta A, Kastrati B, Dreshaj S. Complications of chronic otitis media with cholesteatoma during a 10-year period in Kosovo. Eur Arch Otorhinolaryngol. 2008;265(12):1477-82.

Samuel J, Fernandes CM, Steinberg JL. Intracranial otogenic complications: a persisting problem. Laryngoscope. 1986; 96(3):272-8.

Dobben D, Rao B, Mafee F, Kamel A, Mercurio S. Otogenic intracranial inflammations: role of magnetic resonance imaging. Top Magn Reson Imaging. 2000;11(2):76-86.

Ooi H, Hilton M, Hunter G. Management of lateral sinus thrombosis: update and literature review. J Laryngol Otol. 2003;117(12):932-9.

Irving M, Jones S, Kendall B, Hall-Craggs A. CT and MR imaging in lateral sinus thrombosis. J Laryngol Otol. 1991;105:693-5.

Altuntas A, Unal A, Aslan A, Ozcan M, Kurkcuoglu S, Nalca Y. Facial nerve paralysis in chronic suppurative otitis media: ankara numune hospital experience. Auris Nasus Larynx. 1998;25(2):169–72.

Yetiser S, Tosun F, Kazkayasi M. Facial nerve paralysis due to chronic otitis media. Otol Neurotol. 2002;23(4):580-8.

Savic L, Djeric R. Facial paralysis in chronic suppurative otitis media. Clin Otolaryngol. 1989;14:515-7.

Kulali A, Ozatik N, Topcu I. Otogenic intracranial abscesses. Acta Neurochir. 1990;107:140-6.

Greenberg S, Manolidis S. High incidence of complications encountered in chronic otitis media surgery in a U.S. metropolitan public hospital. Otolaryngol Head Neck Surg. 2001;125:623-7.

Jun L, Seong C, Keehyun P, Yun-Hoon C. Managements for lateral sinus thrombosis: does it need the ligation of internal jugular vein or anticoagulants? Eur Arch Otorhinolaryngol. 2009;266:51-8.

Shah K, Jubelirer F, Fish D, Elden M. A caution regarding the use of low-molecular weight heparin in pediatric otogenic lateral sinus thrombosis. Int J Pediatr Otorhinolaryngol. 2007;71(2):347-51.

Bradley T, Hashisaki T, Mason C. Otogenic sigmoid sinus thrombosis: what is the role of anticoagulation? Laryngoscope. 2002;112:1726-9.