Complications Of Suppurative Otitis Media Research Articles

Identification of Risk Factors for Mortality and Prolonged Hospitalization in Patients Treated With Surgical Drainage for Otogenic Intracranial Complications: A Nationwide Study Using a Japanese Inpatient Database.

Data on risk factors for otogenic intracranial complications including cerebral abscess have been limited. Using a nationwide database, the aim was to identify the factors related to mortality and delayed discharge. Retrospective. Nationwide database using the Diagnostic Procedure Combination database. Data of 145 patients were extracted from a Japanese inpatient database between 2012 and 2020. The main outcome was survival at discharge. In a subgroup analysis of the 137 surviving patients, the second outcome was delayed discharge. The mortality rate was 5.5% (8 of 145). Logistic regression analyses identified intracerebral complications (adjusted odds ratio [OR], 3.09) and more than 2-day delay of the first surgery after admission (adjusted OR, 4.68) as risk factors for mortality. Specifically, consciousness level evaluated by the Japan Coma Scale (JCS) was significantly related to prolonged hospitalization or mortality: JCS I (adjusted OR, 3.40) and JCS ≥II (adjusted OR, 25.1). Although otogenic intracranial complications are rare, and their mortality is decreasing because of the progress in imaging and clinical strategies, they remain the most severe complications of suppurative otitis media and/or cholesteatoma. Consciousness level at admission, comorbid diabetes mellitus, and a greater than 2-day delay of surgical intervention were related to prolonged hospitalization or mortality.

Complications Of Suppurative Otitis Media Still Occur In The 21st Century

Chronic suppurative otitis media is chronic inflammation affected the middle ear and divided in 2 types benign and malignant type, Where the complication most aggressive with the malignant type. This study is aretrospective chart review for files of patients with suppurative otitis media complicated with one or more of the cranial and or intra-cranial complications of CSOM and attended to Assiut University Hospital (AUH) for management of their diseases during the 10 years from 1- 1-2005 to 31-12-2014. The patients were grouped into 3 groups: Group I: - with Cranial complications. Group II: - with Intra-cranial complications. Group III: - with mixed complications. The aim of study was to Identification of cases with different cranial and intra-cranial complications of suppurative otitis media that presented to AUH from 1-1-2005 to 31-12-2014, analyzing the factors surrounding these patients with complications, and Identification of the ways of management done.

Clinical analysis of complications of suppurative otitis media in children

Objective:To summarize and analyze the clinical manifestations and surgical treatment for complications of suppurative otitis media in children. Method:The characteristic of 35 children under 14 years old with suppurative otitis media who had no response to conservative treatment were analyzed retrospectively. Of the patients, 23 cases（65.7%） with subperiosteal abscess, 7 cases （20.0%） with peripheral facial paralysis, 2 cases（5.7%） with brain abscess, 1 case（2.9%） with Bezold abscess, 1 case（2.9%） with labyrinthitis, 1 case （2.9%） with sigmoid sinus thrombophlebitis. Thirty cases（85.7%） were less than 5 years old. The operation methods included mastoidotomy（17 cases）, mastoidotomy combined with grommet insertion（12 cases）, canal wall up mastoidectomy（4 cases）, canal wall down mastoidectomy（2 cases）. Result:CT examination showed that 6 cases of middle ear infection complicated with extensive bone destruction in mastoid process, middle cranial fossa base and auditory ossicles. The severity of hearing loss was positively correlate to the presence of auricular meatus purulence（P<0.05）, but not to the onset time of hearing loss, disease duration and the bacteria species（P>0.05）. After a 6 months postoperative follow-up, all the wounds were well recovered. 26 patients received audiology tests at 3 months after operation, 18 cases with normal hearing or mild conductive hearing loss preoperatively had normal hearing after operation, 2 cases with moderate conductive hearing loss had a 10-15 dB HL increase in air-bone gap after operation,hearing reconstructions surgery was not performed in 1 case of severe mixed hearing loss and 1 case of moderate conductive hearing loss due to serious damage in the middle ear structure, therefore no significant improvement in hearing in these two cases,four cases with extremely severe hearing loss before the operation had no hearing improvement, while nine cases did not provide the hearing results. Conclusion:The symptoms of otitis media in children were not obvious while the complications could be severe, especially in younger children. Repeatedly auricular meatus purulence may indicate hearing impairment. Microbiological examination should be conducted at the early stage, and prompt treatment should be performed based on hearing and temporal bone CT scan to prevent irreversible complications and sensorineural hearing impairment.

Otogenic brain abscesses: A systematic review.

ObjectiveOtogenic brain abscesses are one of the most significant life‐threatening complications of otologic infections. Given their low prevalence, otogenic brain abscesses require a high index of suspicion for diagnosis. In this systematic review, we aim to provide an analysis of otogenic brain abscesses and describe common clinical signs and symptoms, bacteriology, location, treatment options, morbidity, and mortality.Data SourcesPubMed, Cochrane CENTRAL database, Google Scholar, and Scopus.MethodsA systematic review of literature was performed using the Preferred Reporting Items for Systematic Reviews and Meta‐analyses recommendations. Variables assessed included clinical signs and symptoms, bacteriology, location, treatment, morbidity, and mortality.ResultsTwenty‐nine studies met inclusion and exclusion criteria, corresponding to a total of 1307 otogenic abscess cases for review. Fifty‐five percent of abscesses were found in the temporal lobe and 28% in the cerebellum. Most patients (88.3%) had a history of suppurative chronic otitis media. The most common symptoms were headache, altered mental status, papilledema, and meningeal irritation. Fever, nausea, and vomiting affected about 40% of patients. The most commonly cultured bacterial species was Proteus mirabilis. In addition to antibiotics, most otogenic brain abscesses were treated by burr hole aspiration. Average mortality following advent of computed tomography was 8.11%.ConclusionAlthough rare, otogenic brain abscesses may occur as a complication of suppurative otitis media and require a high index of suspicion. Appropriate imaging studies and multidisciplinary expertise are crucial in the diagnosis and management.Level of Evidence4.

Stenotrophomonas maltophilia causing Gradenigo’s syndrome

We report Stenotrophomonas maltophilia as a cause of Gradenigo’s syndrome, a rare complication of suppurative otitis media (OM). The clinical triad of sixth nerve palsy, OM and pain in the distribution of trigeminal nerve constitute the diagnosis of Gradenigo’s syndrome. Common organisms that have been recovered include; Group A Streptococcus, Pneumococcus, Staphylococcus, Pseudomonas aeruginosa and Mycobacterium tuberculosis. Our aim is to report the first case of Gradenigo’s syndrome caused by S. maltophilia, an aerobic, non-fermentative, Gram-negative bacterium which causes uncommon but difficult to treat infections in humans. Rare pathogens such as S. maltophilia should be included in the differential diagnosis of organisms causing complicated non-responding OM even if the host is immunocompetent.

English

Suppurative otitis media is a common occurrence and so are its complications. Its various complications are of frequent occurrence in otorhinolaryngology clinics. The incidence of extracranial ones are still posing a problem to the otologists Present work has been, undertaken from September 2010 to September 2012 to study the incidence of extracranial complications in relation to suppurative otitis media and to study the clinical presentation and pathology of extracranial complications of suppurative otitis media. Total 6130 cases of suppurative otitis media were observed (23.96%). Out of these patients 4890 cases (19.11%) were having chronic suppurative otitis media (CSOM) and 1240 cases (4.85%) had acute suppurative otitis medi (ASOM).In the present study, it is seen that 23.96% of total patients were having suppurative otitis media. The incidence of complications due to ASOM is 1.45%. Mastoiditis comprises of 59.35% of total extracranial complications and is the commonest in the present series followed by subperiosteal abscess, labyrinthitis and facial palsy. The prevalence can be decreased by means of health awareness regarding how to take care of the ear and when to report the physician.

Role of CT Scan in Diagnosis and Management of Otogenic Intracranial Abscess

The existence of complications of suppurative otitis media and efforts to control it go far back into history. Early diagnosis and management have been greatly modified by the extensive use of CT scan and higher antibiotics. Despite an overall decline in the incidence of complications of otitis media, severe complications still exist with high mortality. Suggested reasons are decrease in physician's experience and changing of the virulence and susceptibility of causative organism. This series is a prospective study of 18 cases of otogenic brain abscess, carried out in Department of ENT and Head & Neck Surgery, SSG Hospital, Baroda from June 2005 to June 2008. We emphasize on confirmation of resolution of brain abscess by CT scan. This will eliminate recurrent/residual abscess and help in reduced overall mortality and morbidity.

Incidence of meningitis secondary to suppurative otitis media in adults

Meningitis is the commonest intracranial complication of suppurative otitis media, and carries the risk of death and life-changing morbidity. This study aimed to estimate the risk of an adult in the UK developing otogenic meningitis. Adults hospitalised with meningitis in Bristol from 1997 to 2002 were identified retrospectively. Cases confirmed by positive blood culture or cerebrospinal fluid investigation were studied. A case was classified as otogenic if there was coexistent evidence of ear infection. Eighty-seven cases of meningitis were analysed. The overall mortality rate was 5.7 per cent. Acute and chronic suppurative otitis media accounted for 13 and three cases, respectively. The adult population of Bristol at the midpoint of the study was 635,976. In this study, the age-adjusted incidence of otogenic meningitis was 0.42 per 100,000 per year.

A study of prevalence of cholesteatoma in complications of suppurative otitis media

Complications of suppurative otitis media are common in developing world. Cholesteatoma has been implicated as the causative factor. We studied 76 cases of suppurative otitis media presented with complica tions and found that only 64% cases had cholesteatoma. Granulation were present in most of the cases of intracranial complications (16.68%).

Acquired medial canal fibrosis.

Acquired medial canal fibrosis is a discrete clinicopathological entity characterized by formation of fibrous tissue in the bony external auditory meatus. Over a seven-year period, a total of 14 operative procedures were performed on 12 ears involving 10 patients. Four cases had followed otitis externa, two were complications of suppurative otitis media, and three cases were iatrogenic. The cause could not be identified in three ears involving two patients. Treatment entails excision of all the fibrous tissue and involved skin, a wide canaloplasty, a meatoplasty, and then reconstruction by split skin graft. Two cases of canal cholesteatoma were encountered. Average follow-up of two years showed hearing improvement in all patients. The only complication was a recurrence of the stenosis in two ears. The paper discusses terminology, aetiology, pathophysiology, diagnosis, and principles of treatment of this condition.

Management of Complications of Suppurative Otitis Media

Educational objective: To review the principles of management of complications of otitis media, emphasizing early recognition.

Extracranial and intracranial complications of suppurative otitis media. Report of 102 cases.

During the eight-year period, 1983-1990, 102 cases of intracranial (IC) and extracranial (EC) complications from 17 144 suppurative otitis media were reviewed. The prevalence of each complication was 0.24 and 0.45 per cent respectively. Facial paralysis, subperiosteal abscess and labyrinthitis were the common complications among the EC group, while meningitis and brain abscess were common in the IC group. Twenty five per cent of the EC group and 44 per cent of the IC group had more than two complications. The reliable warning signs and symptoms for IC complications were fever, headache, earache, vestibular symptoms, meningeal signs and impairment of consciousness. Proteus spp., Pseudomonas aeuruginosa and Staphylococcus spp. were the commonest organisms isolated from both groups. Cholesteatoma and granulation/polyp in the middle ear/mastoid were the major findings in both patient groups. Mortality rate in the IC group was 18.6 per cent. Morbidity rate in each group was 14.3 per cent (EC) and 27.9 per cent (IC) respectively. Epidemiological presentations, clinical features and the result of treatment are discussed.

LATERAL SINUS THROMBOSIS

The incidence of lateral sinus thrombophlebitis has been significantly reduced since the advent of antibiotics. This entity is rarely encountered in clinical practice, so a high index of suspicion is essential for early diagnosis and appropriate management. Although uncomplicated dural venous thrombosis carries an excellent prognosis with proper treatment, delay in diagnosis and institution of appropriate therapy may lead to serious, or even fatal, consequences. It is hoped that this case report and discussion will serve to increase the awareness of lateral sinus thrombophlebitis as a potential complication of suppurative otitis media.

THROMBOSIS OF THE SIGMOID SINUS: A CLINICAL ANALYSIS

Septic thrombophlebitis of the sigmoid sinus remains, as it has been for many years, one of the most intriguing complications of suppurative otitis media. Instances of this condition comprise but a small portion of the relatively large number of cases of suppurative otitis media associated with sepsis. The term as used signifies an infected clot, mural or occluding, from which particles gain entrance into the blood stream and produce septicemia. True septicopyemia with a positive blood culture and metastatic abscesses is not found in every case. The broader term "sepsis" is usually applied, indicating the condition of a patient who is acutely ill of an infection and who presents chills, intermittent high fever giving the "picket fence temperature curve," leukocytosis and secondary anemia. Having ruled out possible extra-aural causes of sepsis, one must bear in mind the fact that infecting organisms in the middle ear and mastoid may gain entrance

BRAIN ABSCESS OF AURAL ORIGIN

ALTHOUGH braini abscess is by no means a rare complication of suppurative otitis media it is sufficienltly uncommilon to make the report of such cases a matter of interest. The following are brief summaries of six cases that have been under miiy care durinig the past year. Thlee have recovered completely, one died of a recur-rence three montlhs after operatiol, alnd two died without the abscess being found at gperation. CASE I. A man, aged 37. He had had left otitis media for many years with offensive discharge and granulation tissue. He was admitted to the Ministry of Pensions Hospital, Liverpool, on October 28th, 1923, in a drowsy, semiconscious state. When first seen by me on November 2nd he was comatose; temperature 970, pulse 40; tongue dry and furred; no eye symptoms. Operation.-The skull was opened through the squiamous temporal and half an ounce of fetid pus evacuated from the temporosphenoidal lobe. During the operation respiration ceased for about half a minute and was not resumed until the abscess had been opened. Uninterrupted recovery followed, and on December 27th he was able to go home for a few days. On January 25th, 1924, a radical mastoid operation was performed. On February 25th he complained of headache and vomited, and a few hours later became comatose with right-sided convulsions and died. Post-mortem examination revealed a large recurrence in the temporo-sphenoidal lobe. The fatal termination was a great surprise to all, since up to the day of his death the temperature and pulse were normal and the man was going about apparently in good health. On retrospect, symptoms that might have aroused suspicion were slight headache, taciturnity, slowness in answering questions, and a certain moodiness and unsociability.

The Operations of Aural Surgery. Together with Those for the Relief of the Intracranial Complications of Suppurative Otitis Media

The LaryngoscopeVolume 20, Issue 9 p. 926-926 Book Review The Operations of Aural Surgery. Together with Those for the Relief of the Intracranial Complications of Suppurative Otitis Media First published: September 1910 https://doi.org/10.1288/00005537-191009000-00020AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume20, Issue9September 1910Pages 926-926 RelatedInformation

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