[Complications of acute otitis media]

Complications of acute otitis media (AOM) are rare but can occur intratemporally or intracranially. Clinically relevant mastoiditis usually presents with subperiosteal abscesses, whereas subclinical opacification of the mastoid cells is common but does not require specific treatment. Other potential complications include labyrinthitis, facial nerve palsy, intratemporal abscess, cerebral venous sinus thrombosis, or meningitis. Diagnosis relies on clinical examination, laboratory tests, and targeted imaging. Intratemporal complications are primarily treated with antibiotics. Surgical intervention is indicated in cases of abscess formation or treatment failure. Intracranial complications often necessitate interdisciplinary surgical management. This review provides practical guidance on differentiation, diagnosis, and treatment, highlighting the importance of recognizing potentially severe courses.