Intracranial complications of suppurative otitis media: 13 years' experience

Among 24,321 patients with otitis media treated at the Otolaryngology Department of Chiang Mai University Hospital from 1978 through 1990, 87 patients had 140 central nervous system complications (0.36%). Multiple complications existed simultaneously in almost 45% of the patients. The group developing the complications were mainly in their second decade of life. Meningitis occurred in 43 patients, brain abscess in 29, perisinus abscess in 23, lateral sinus thrombosis in 16, and extradural abscess in 12 patients. The most striking symptoms and signs were increasing otorrhea, visible cholesteatoma and/or granulations, fever, headache and otalgia, and vestibular symptoms. Proteus mirabilis, Pseudomonas aeruginosa, and staphylococcal organisms were found in almost 80% of patients. Overall mortality was 18.4% with brain abscess being the main cause (31%). Epidemiologic presentation, clinical features, and results of treatment for each disease are compared and contrasted to those of previous studies.