title: Epidemiology of intratemporal complications of otitis media.
abstract: Introduction Despite the advent of antibiotics and immunizations in the last century, complications of otitis media remain quite frequent, have high morbidity and mortality rates, and pose a challenge to the otorhinolaryngologist. Objective To establish the annual incidence of intratemporal complications of otitis media and prospectively evaluate patients via an analysis of epidemiologic and clinical aspects. Methods Prospective, observational study. Between February 2010 and January 2011, patients admitted to a tertiary care, university-based otology practice with diagnosis of otitis media and an associated intratemporal complication (ITC) were included in the study. The following data were evaluated: age, sex, type of ITC, treatment, imaging tests findings, type and degree of hearing loss, and clinical outcome. The overall incidence of all complications and of each complication individually was determined. Results A total of 1,816 patients were diagnosed with otitis media. For 592 (33%) individuals, the diagnosis was chronic otitis media; for 1,224 (67%), the diagnosis was acute otitis media. ITCs of otitis media were diagnosed in 15 patients; thus, the annual incidence of intratemporal complications was 0.8%. We identified 19 ITC diagnoses in 15 patients (3 patients had more than one diagnosis). Labyrinthine fistulae were diagnosed in 7 (36.8%) individuals, mastoiditis in 5 (26.3%), facial palsy in 4 (21.1%), and labyrinthitis in 3 (15.8%). Conclusion The incidence of intratemporal complications in Brazil remains significant when compared with developed countries. Chronic otitis media with cholesteatoma is the most frequent etiology of intratemporal complications. Labyrinthine fistula is the most common intratemporal complication.
authors.affiliation: Department of Otolaryngology, Universidade Federal de São Paulo - UNIFESP, Rua Dos Otonis, Sao Paulo, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Maranhão
authors.affiliation: Department of Otolaryngology, Universidade Federal de São Paulo - UNIFESP, Rua Dos Otonis, Sao Paulo, Brazil.
authors.forename: José
authors.initials: J
authors.lastname: Andrade
authors.affiliation: Department of Otolaryngology, Universidade Federal de São Paulo - UNIFESP, Rua Dos Otonis, Sao Paulo, Brazil.
authors.forename: Valéria
authors.initials: V
authors.lastname: Godofredo
authors.affiliation: Department of Otolaryngology, Universidade Federal de São Paulo - UNIFESP, Rua Dos Otonis, Sao Paulo, Brazil.
authors.forename: Rafaela
authors.initials: R
authors.lastname: Matos
authors.affiliation: Department of Otolaryngology, Universidade Federal de São Paulo - UNIFESP, Rua Dos Otonis, Sao Paulo, Brazil.
authors.forename: Norma
authors.initials: N
authors.lastname: Penido
keywords: otitis media; suppurative otitis media; temporal bone