Intracranial Complications of Chronic Suppurative Otitis Media: Clinical Presentation and Outcome of Surgical Procedures

Abstract

Background: Chronic suppurative otitis media is a common disease of younger ages which may lead to fatal and other dreadful complications. The objective of this study was to describe the clinical presentation of intracranial complications of chronic suppurative otitis media and outcome of various otological surgical procedures in management of these complications. Material & Methods: This descriptive study was conducted at Department of ENT, Hayatabad Medical Complex, Peshawar, from January 2007 to December 2011. All admitted cases of intracranial complications due to chronic suppurative otitis media of any age and gender were included. Cases of intracranial complications due to acute suppurative otitis media were excluded from the study. After confirmation of complications by computed tomography, a multidisciplinary approach was followed by medical, neurosurgical and ENT departments, including initial treatment by intravenous systemic antibiotics to the definitive final treatment of mastoid surgery. Results: With total 35 patients, mean age was 25.43+9.67 years, range 10-50 years and male to female ratio was 2:1. The most frequent symptom, general sign, otological sign, intracranial complication, surgical procedure and morbidity were otorrhoea 35(100%), raised temperature 27(77.14%), cholesteatoma 24(68.57%), meningitis 14(40%), radical mastoidectomy 23(65.71) and epilepsy 3(8.57%) respectively with no mortality. Conclusion: Meningitis is the commonest intracranial complication of chronic suppurative otitis media followed by brain abscess. Early surgical intervention in combination with broad spectrum antibiotics provides a good outcome.