Acute complications of otitis media in adults.
OBJECTIVE
To establish the incidence, current treatment and outcome of adult patients with acute intratemporal and intracranial complications of otitis media (OM).


METHODS
A retrospective chart review with a sent questionnaire.


METHODS
Tertiary referral centre, University hospital.


METHODS
Adult patients treated for acute intratemporal and intracranial complications of OM over the past 15 years (1990-2004) in the study hospital.


METHODS
Incidence, treatment and outcome of patients with intratemporal and intracranial complications of OM.


RESULTS
Fifty patients aged 16-75 years were treated. The annual age-adjusted incidence of acute intratemporal and intracranial complications was 0.32/100 000. Forty-one (82%) of the complications were intratemporal and nine (18%) were intracranial. The ear disease behind the acute complication was acute otitis media (AOM) in 80% (40/50), chronic otitis media (COM) in 12% (6/50) and COM with cholesteatoma in 8% (4/50). Mastoiditis was complicated by subperiosteal abscess, labyrinthitis and facial paresis in 7% (3/41), 15% (6/41) and 32% (13/41) respectively. Mastoidectomy was performed on 56% (28/50) of the patients. Four (44%) of the intracranial complications were intracranial abscesses, four (44%) were meningitis and one (11%) was sinus thrombosis. Permanent hearing loss occurred in 13 (26%) patients and one patient died due to otogenic meningitis.


CONCLUSIONS
Severe complications of the OM in adults are rare in Finland. The commonest cause is AOM rather than COM. Operative treatment is predominantly needed for intracranial complications and intratemporal abscesses. Complications of OM are still associated with considerable morbidity, and early recognition is most likely to form the basis for effective treatment.
Leskinen
K
K
Department of Otolaryngology, Helsinki University Central Hospital, Haartmaninkatu 4E, PO Box 220, FIN-00029 HUCH, Helsinki, Finland. kimmo.leskinen@hus.fi
Jero
J
J
D000038:Abscess / Q000209:etiology; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000209:etiology; D018424:Cholesteatoma, Middle Ear / Q000150:complications; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D007762:Labyrinthitis / Q000209:etiology; D008297:Male; D008416:Mastoid / Q000601:surgery; D008417:Mastoiditis / Q000209:etiology; D008581:Meningitis / Q000209:etiology; D008875:Middle Aged; D008876:Middle Ear Ventilation; D010033:Otitis Media / Q000150:complications*; D012189:Retrospective Studies; D012851:Sinus Thrombosis, Intracranial / Q000209:etiology; D013701:Temporal Bone / Q000473:pathology; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery
D000900:Anti-Bacterial Agents