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Abstract
Keywords Chronic otitis media ComplicationsTo the Editor,The article by E. Yorgancilar et al. [1] presents interestingand very important clinical observations. The authorsdescribed clinical data and therapeutic approach to 121patients with EC and IC complications of CSOM. Theypresented methods of treatment and epidemiological dataof these complications (the most common was subperios-teal abscess—28.3 % and lateral sinus thrombophlebitis—19.5 %). The decrease in mortality in the authors’ clinicfrom 16.1 to 0 % is an excellent result and we would like tocongratulate on it. Let us present some comments on thisproblem on the basis of our clinical experience. In the lastyears the outcome of treatment of these conditions is sig-nificantly better than in the past. Presently intracranialcomplications of CSOM are very rare in our Department asmost commonly EC intricacy is observed. In the data (inthe years 2001–11) of our Department we found 98 cases(86-EC and 12-IC) of CSOM otogenic complications. Themost frequent EC intricacy was labyrinthitis and the mostpopular IC one was lateral sinus thrombophlebitis. Nowa-days the symptoms of complications are less prominentthan in the past due to antibiotic treatment of COM prior tohospital admission. The time required for full diagnosisof patients with complicated COM is reduced due to CTwith contrast and MRI availability (useful to diagnoseextradural abscess, subdural empyema, meningitis orthrombophlebitis of the dural veins). This technique isparticularly useful in children [2] (Fig. 1).In connection with the article let us ask some questionsto the authors: Were all of the patients operated on pri-marily? Why were the extradural abscesses and the tem-poral lobe abscesses not evacuated during the mastoidsurgery? Temporal lobe abscesses may be evacuated dur-ing ear surgery (by puncture and aspiration). In this methodof temporal lobe abscesses evacuation neuronavigation is avery serviceable tool. Neurosurgical approach to the
Highlights
Yorgancilar et al [1] presents interesting and very important clinical observations
Intracranial complications of CSOM are very rare in our Department as most commonly EC intricacy is observed
In the data of our Department we found 98 cases (86-EC and 12-IC) of CSOM otogenic complications
Summary
Yorgancilar et al [1] presents interesting and very important clinical observations. The authors described clinical data and therapeutic approach to 121 patients with EC and IC complications of CSOM. They presented methods of treatment and epidemiological data of these complications (the most common was subperiosteal abscess—28.3 % and lateral sinus thrombophlebitis— 19.5 %). Let us present some comments on this problem on the basis of our clinical experience.
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