Background: This study aims to present our experiences regarding otitis media (OM) complications in a tertiary hospital and discuss them in light of the literature.
Methods: In our study, the demographic information, findings at admission, radiological examinations, treatment approaches, and follow-up periods of the patients treated for OM complications at Dokuz Eylül University Hospital Ear Nose and Throat Clinic between January 2010 and January 2024 were retrospectively analyzed. Complications were grouped as acute otitis media (AOM), chronic otitis media (COM), and extracranial and intracranial complications.
Results: In the study, 74 complications were observed in 67 patients, 44 of which were due to AOM and 30 due to COM. Thirty-nine patients were male (58.2%) and 28 were female (41.8%). The mean age was 28.7 years (2 months-78 years). Twenty-eight of the COM complications were extracranial, and 2 were intracranial. Extracranial complications consisted of 14 perilymphatic fistula (PLF), 11 cases of peripheral facial paralysis (PFP), 2 subperiosteal abscesses, and 1 Citelli abscess. There was a temporal lobe abscess and a sigmoid sinus thrombosis as intracranial complications. More than 1 complication was observed in 3 patients. A patient treated for temporal lobe abscess underwent radical mastoidectomy along with neurosurgery and intracranial abscess drainage. In 14 patients with PLF, the fistula was repaired with bone pates and soft tissues after the appropriate removal of the cholesteatoma. We managed to preserve hearing in all of these patients. While complete recovery was observed in 6 of the 11 PFP patients who underwent surgery, 3 patients had grade 2 PFP and 1 patient had grade 3 PFP according to the House–Brackmann staging system at the last follow-up. One patient voluntarily lost follow-up after the first month of the operation. Modi!ed radical mastoidectomy and medical treatment were applied to the patient who was diagnosed with sigmoid sinus thrombosis. At the second-month follow-up, it was observed that the thrombosed segment in the sinus was recanalized. Forty-four AOM complications were treated in 40 patients. Extracranial complications were listed as 14 subperiosteal abscesses, 10 cases of mastoiditis, 6 cases of labyrinthitis, and 4 PFP. Among the intracranial complications, sigmoid sinus thrombosis was observed in 6 patients, epidural abscess was observed in 3 patients, and otitic hydrocephalus was observed in 1 patient. All patients with subperiosteal abscesses underwent abscess drainage and a ventilation tube in addition to intravenous antibiotic therapy. Patients with PFP and labyrinthitis were treated with a ventilation tube, and patients were also given antibiotics and oral steroids. Intravenous antibiotics, abscess drainage, mastoidectomy, and anticoagulant treatment were applied to patients presenting with epidural abscess and sigmoid sinus thrombosis. Another remarkable situation is that after the emergence of the COVID-19 pandemic, AOM was the increase in complications. Eleven cases of AOM complications in 10 years before the pandemic. Thirty-three cases of AOM complications were observed after the emergence of the pandemic. Three of these 33 cases were diagnosed during the period when pandemic measures were implemented, including curfew, personal hygiene, wearing masks, and closing schools, while 30 were diagnosed after September 2021, when schools reopened after the pandemic and the measures were reduced. It is attractive.
Conclusion: Otitis media complications are pathologies in which signi!cant morbidity and mortality can be prevented thanks to early diagnosis and treatment. In addition, these complications increased after the COVID-19 pandemic. For this reason, early diagnosis and treatment are important, as they are lifesaving.
Cite this article as: Öncül EC, Olgun Y, Savaş Ö, Çakır Çetin A, Güneri EA. Our 14 years of clinical experience in otitis media complications. Balkan ORL-HNS 2025;2(1):15-21.