Complications of Chronic Suppurative Otitis Media

Antibiotics have produced an overall decline in the frequency of complications of otitis media relative to the preantibiotic era. However, severe complications still occur and may be associated with high mortality. Intracranial and extracranial complications of acute and chronic otitis media are possible. A discussion of the diagnosis and management of these complications is the focus of this article.

Spread of infection from the ear and temporal bone causes intracranial complications of otitis media. Spread of infection occurs through 3 routes, namely, direct extension, thrombophlebitis, and hematogenous dissemination. Extracranial complications are usually direct sequelae of localized acute or chronic inflammation.The complications of otitis media include the following:

• Chronic suppurative otitis media
• Postauricular abscess
• Facial nerve paresis
• Labyrinthitis
• Labyrinthine fistula
• Mastoiditis
• Temporal abscess
• Petrositis
• Intracranial abscess
• Meningitis
• Otitic hydrocephalus
• Sigmoid sinus thrombosis
• Encephalocele
• Cerebrospinal fluid (CSF) leak