COMPLICATIONS OF CHRONIC SUPPURATIVE OTITIS MEDIA
Complications are usually seen in Active Squamosal type of COM with Cholesteatoma.
Mode of spread of infection
- Direct extension through the de-mineralized bone seen in cholesteatoma.
- Blood borne spread via the veins, through bone and dura to venous sinuses, more common in acute infections. Lateral sinus thrombophlebitis causes spread of infection to the cerebellum.
- Through round or oval window into the auditory meatus on the vestibular aqueducts.
- Dehiscence of bony covering over the jugular bulb or the tegmen tympani.
- Neoplastic or accidental bone erosion.
- Through surgical defect in post Stapedotomy surgery.
Complications of CSOM
General symptoms of Intracranial complications are due to
- 1. Symptoms due to the infection.
- 2. Compression of brain tissue.
Clinical features
- Headache.
- Malaise.
- Fever, drowsiness.
- Neck rigidity with Kernig’s sign positive.
- Hemiplegia with cranial nerve symptoms.
Treatment:
- Systemic antibiotics to control infection.
- Mastoidectomy to remove ear infection and cholesteatoma.
- Neurological opinion to manage the intracranial abscess.
Treatment of Intratemporal infection includes
- Systemic antibiotics to control infection.
- Drainage of abscess.
- Mastoidectomy to remove ear infection and cholesteatoma.