Severity patterns in chronic otomastoiditis: a retrospective single-center study

Chronic otomastoiditis can cause local structural destruction and clinically important complications. This retrospective single-center study described severity patterns and diagnostic investigation use during 2020-2024. The analysis included 137 clinical records of chronic otomastoiditis. Clinical complications were distinguished from structural defects and ossicular erosion. Frequencies, descriptive between-group differences, and missing-data sensitivity analyses were calculated. Inferential tests were not applied because patient-level independence could not be verified throughout the dataset. Mean ± standard deviation age was 41.8 ± 16.4 years. At least one clinical complication was present in 13/136 (9.6%); an expanded endpoint including tegmen dehiscence and posterior external auditory canal wall fistula was positive in 15/136 (11.0%). Facial paralysis occurred in seven records and semicircular canal fistula in five. Computed tomography was performed in 131/137 (95.6%), and magnetic resonance imaging in 17/137 (12.4%). Complications occurred in 8/17 (47.1%) records with vertigo versus 5/119 (4.2%) records without vertigo. Corresponding proportions with and without magnetic resonance imaging were 4/17 (23.5%) and 7/71 (9.9%). Microbiological information was interpretable in 39 records, with organisms identified in 25. Structural injury and clinical complications represented different dimensions of severity. Vertigo showed a marked descriptive association with complications. Imaging comparisons were limited by indication bias and missing information and did not establish diagnostic accuracy or independent predictors.