Complications of otitis media

Due to available medical care and antibiotics, the incidence of mesotitis complications is relatively low. They most often arise as a complication of 'chronic mesotitis with cholesteatoma.

An infection can "'spread'" from the middle ear in several ways:

1. by innate preformed paths;
2. obtained by preformed paths;
3. usuri in the bone;
4. in osteothrombophlebitis.

In general, complications can be divided into:

• otological';
• intracranial.

Otological complications

Coalescent mastoiditis

 For more information see Mastoiditis.

Petrositida

• This is inflammation of the glomeruli of the pyramid' and the formation of an abscessed deposit. Nowadays, this complication occurs only rarely.
• Clinically, we describe the so-called Gradenig syndrome, which includes fever, otorrhea, retrobulbar pain and diplopia.
• 'CT is mainly used in diagnostics.
• Treatment consists of the administration of antibiotics', in case of failure, surgical intervention can be performed (mastoidectomy, petrosectomy).

Paresis of the facial nerve

• In an acute infection, the nervus facialis is damaged by toxins'.
• In a chronic infection, the nervus facialis is compressed by a cholesteatoma'.
• In both cases it is a peripheral facial nerve paresis.

Labyrinthitis

We distinguish 3 forms of labyrinthitis':

1. Perilabyrinthitis: In perilabyrinthitis, the cholesteatoma damages the bony capsule of the labyrinth and creates a labyrinthine fistula, which can be visualized by HRCT. The inner ear is not infected. The dominant symptom is vertigo.
2. Serous labyrinthitis: As a result of the penetration of microorganisms or their toxins into the inner ear, a reversible inflammation occurs. Clinical symptoms include tinnitus, hypacusia (perceptual defect).
3. Suppurative labyrinthitis': It is caused by the penetration of virulent microorganisms into the inner ear. The clinical picture' is severe - severe vertigo, tinnitus, nausea, vomitus, nystagmus, balance disorders. The great danger lies in the possibility of the infection spreading to the brain and cerebellum - the condition needs to be dealt with immediately (ATB, labyrinthectomy). The inevitable consequence of the disease is deafness.

Residues post otitis media

• Atrophy, atelectasis of the tympanic membrane, calcareous incrustations, perforation.

Intracranial complications

Intracranial complications include:

• meningitis;
• 'thrombophlebitis of the ace-shaped raft
  • usually a complication of mastoiditis, first a perisinusoidal abscess develops, then a mural thrombus, which becomes infected and spreads retrogradely and anterogradely,
  • leads to bacteremia and the formation of secondary abscesses in the lungs, endocardium and brain,
  • treatment is surgical - mastoidectomy and removal of the float;
• epidural or brain abscess,
• subdural empyema.

Links

Related Articles

• Classification of otitis media
• Facial nerve paresis/PGS/diagnosis

Source

• BENEŠ, George. Study Materials [online]. ©2007. [cit. 2009]. <http://jirben2.chytrak.cz/materialy/orl_jb.doc>.

References

• KLOZAR, Jan. Special otorhinolaryngology. 1. edition. Galen, 2005. 224 pp. ISBN 80-7262-346-X.

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