The Complications of Acute and Chronic Otitis Media
Intra-cranial Complications
Intratemporal Complications
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Labyrinthitis
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Ossicular fixation or erosions
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Labyrinthine fistula
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Facial nerve paralysis
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Mastoiditis / Mastoid abscess
Extracranial Complications
- Extension of infection to the neck
- Bezold abscess (extension of infection from mastoid to SCM)
I/D
Table Complications otitis media
Objectives
- The predisposing factors for complications
- The pathways for spreading the infections beyond the ear
- To know the classifications of complications
- To know presentations, clinical findings, investigations, and management of each complication
Predisposing Factors
- Virulent organisms
- Chronicity of disease
- Presence of Cholesteatoma and bone erosion
- Obstruction of natural drainage (e.g., by a polyp)
- Low resistance of the patient
Pathways of Infection
- Extension of infection is by bone erosion due to a cholesteatoma
- Vascular extension (retrograde thrombophlebitis)
- Congenital dehiscence
- Fracture lines
- Round or oval window membrane to the labyrinth
- Dehiscence due to previous surgery
Classification
- Intra-cranial complications
- Intratemporal complications
- Extra-cranial complications
What are the natural barriers between the brain and temporal bone?
- Bone
- Meninges