title: Complications of Chronic Suppurative Otitis Media and Their Management: A Single Institution 12 Years Experience.
abstract: To determine the incidence of otogenic complications of Chronic suppurative otitis media (CSOM) and its management. The study was conducted at the tertiary referral centre and teaching hospital. An analysis was made about the clinical and operative findings, surgical techniques and approaches, the overall management and recovery of the patient. The data were then compared with the relevant and available literature. Over the study period of 12 years, a total 45 cases of CSOM with complications were reviewed. Out of these 45 cases, 20 cases had extracranial (EC) while 25 cases had intracranial (IC) complications. The prevalence of each complication was 0.17 and 0.13 %, IC and EC respectively. The commonly encountered IC complications were brain abscess, meningitis and lateral sinus thrombophlebitis. Among the EC complications, mastoid abscess followed by labyrinthitis and facial nerve palsy were encountered. The reliable warning signs and symptoms of IC complications were fever, headache, earache vestibular symptoms, meningeal signs and impairment of consciousness. Proteus mirabilis, Pseudomonas aeruginosa, Staphylococcus epidermidis were the common organism isolated. Cholesteatoma and granulation in the middle ear were the major findings in both groups of cases. Surgery was main modality of management of these conditions. We observed that two patients fail to regain full facial nerve function despite of surgery. Mortality rate was zero but morbidity was seen in 15 % (3) and 28 % (7) of cases in EC and IC group respectively. The epidemiological presentation, clinical features and results of treatment are discussed. 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. In this study we emphasize the importance of the accurate and early diagnosis followed by adequate surgical therapy with multidisciplinary approach.
authors.affiliation: Department of ENT & Head Neck Surgery, J.L.N.Hospital & Research Centre, Quarter 5B, Street no. 28, Sector 9, Bhilai, Dist. Durg, 490009 Chhattisgarh India.
authors.forename: Neeta
authors.initials: N
authors.lastname: Sharma
authors.affiliation: Department of ENT & Head Neck Surgery, J.L.N.Hospital & Research Centre, Quarter 5B, Street no. 28, Sector 9, Bhilai, Dist. Durg, 490009 Chhattisgarh India.
authors.forename: Ashwin Ashok
authors.initials: AA
authors.lastname: Jaiswal
authors.affiliation: Department of ENT & Head Neck Surgery, J.L.N.Hospital & Research Centre, Quarter 5B, Street no. 28, Sector 9, Bhilai, Dist. Durg, 490009 Chhattisgarh India.
authors.forename: Praveer Kumar
authors.initials: PK
authors.lastname: Banerjee
authors.affiliation: Department of ENT & Head Neck Surgery, J.L.N.Hospital & Research Centre, Quarter 5B, Street no. 28, Sector 9, Bhilai, Dist. Durg, 490009 Chhattisgarh India.
authors.forename: Amrish Kumar
authors.initials: AK
authors.lastname: Garg
keywords: Cerebellar abscess; Chronic suppurative otitis media (CSOM); Extracranial complications; Intracranial complications; Lateral sinus thrombophlebitis; Meningitis