Complications of chronic suppurative otitis media and their management.
OBJECTIVE
The objective of this is to determine the incidence of otogenic complications of chronic suppurative otitis media (CSOM) and its management.


METHODS
The authors conducted a retrospective study.


METHODS
The study was conducted at the tertiary referral and teaching hospital. An analysis was made about the clinical and operative findings, surgical techniques and approaches, the overall management and recovery of the patients. The data were then compared with the relevant and available literature.


RESULTS
Of the 70 cases, 47 (67%) had a single complication, of which eight (11%) had intracranial and 39 (56%) had extracranial complications. Twenty-three (33%) had two or more complications. The commonly encountered intracranial complications were otitic meningitis, lateral sinus thrombosis, and cerebellar abscess, which were seen in 13 (19%), 10 (14%), and 6 (9%) cases, respectively. Among the extracranial complications, mastoid abscess, postauricular fistula, and facial palsy were encountered in 26 (37%), 17 (24%) and 10 (14%) patients, respectively. Surgeries were the main mode of treatment for these conditions. According to severity, we found four different types of the lateral sinus involvement. Three patients with otitic facial palsy failed to regain full facial function despite surgery. A total of nine patients with the diagnosis of otitic meningitis, lateral sinus thrombosis and interhemispheric abscess expired. It constituted the mortality rate of 13% in our study.


CONCLUSIONS
CSOM complications, despite its reduced incidence, still pose a great challenge in developing countries as the disease present in the advanced stage leading to difficulty in management and consequently higher morbidity and mortality.
Dubey
Siba P
SP
Department of Ear, Nose and Throat, Port Moresby General Hospital, Papua, New Guinea. dubeysp@datec.net.pg
Larawin
Varqa
V
D000038:Abscess / Q000209:etiology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D001847:Bone Diseases / Q000209:etiology / Q000601:surgery; D001922:Brain Abscess / Q000209:etiology / Q000601:surgery; D002423:Cause of Death; D002526:Cerebellar Diseases / Q000209:etiology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005158:Facial Paralysis / Q000209:etiology / Q000628:therapy; D005260:Female; D005402:Fistula / Q000209:etiology / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D008416:Mastoid / Q000473:pathology / Q000601:surgery; D008581:Meningitis / Q000209:etiology / Q000601:surgery; D008875:Middle Aged; D010035:Otitis Media, Suppurative / Q000150:complications*; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D012851:Sinus Thrombosis, Intracranial / Q000209:etiology / Q000601:surgery