Common Complications Of Chronic Suppurative Otitis Media(CSOM)!

The advent of new age antibiotics has led to an overall decline in the frequency of complications of diseases, and chronic suppurative otitis media is no exception to this. But there is still room for severe complications of the disease related to high mortality, and in most cases, extracranial and intracranial complications of acute and chronic otitis media are seen to be the root cause.

An overview of the complications of the disease
A chronic suppurative otitis media is a condition characterized by chronic inflammation in the middle ear cavity and mastoid cavity.

When the infection spreads from the ear and temporal bone, it leads to intracranial complications of otitis media. This may take place through three routes which include hematogenous dissemination, thrombophlebitis, and direct extension. On the other hand, extracranial complications are generally sequelae of the local chronic or acute complication. The complications of otitis media include-

• Leakage of cerebrospinal fluid
• Temporal abscess
• Encephalocele
• Petrositis
• Sigmoid sinus thrombosis
• Postauricular abscess
• Paresis of facial nerve
• Mastoiditis
• Labyrinthine fistula
• Labyrinthitis
• Meningitis
• Otitic hydrocephalus

The overall number of complications of suppurative otitis media has reduced to a great extent with the availability of effective microbial treatment options before which the incidence of mastoiditis needing surgical treatment was around 25 to 50 percent.

What are the reasons behind the complications of suppurative otitis media?

The risk of complications related to chronic suppurative otitis media can surge when an acute episode of otitis media persists for over 2 weeks or in case the symptoms recur within 2 or 3 weeks. Even though there is the availability of adequate treatment, an approximate one-third of individuals who suffer from meningitis tend to develop permanent neurologic sequelae. They may also develop seizures and other behavioral disorders.

What are the signs and symptoms of chronic suppurative otitis media?
Fever accompanied by a headache is the most commonly observed manifestations of complications of the disease. The complications associated with otitis media include fetid otorrhea, lethargy, severe otalgia, vertigo and alterations in status changes. According to experts, a high index of suspicion is imperative for diagnosing the actual complication of otitis media. The complications are normally associated with chronic and subacute infections, but acute otitis media remains the most frequently manifested issue. When there is meningitis in the setting of acute suppurative otitis media, it may indicate anatomic abnormality like Mondini malformation. The intracranial and extracranial complications are unique to each individual, and therefore, it needs to be dealt with utmost precision and expertise. Imaging studies such as CT scanning, MRI, and electrical excitability tests are required for discerning the issues concerning the health issue.

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