Intra and extracranial complications of middle earths: literature review

Abstract

Otitis media (OM) has several forms and among the main are otitis media (AOM), OM with effusion and chronic otitis media (COM) (cholesteatomatous or not). For the most part, the OM progressed well, but there are risks of complications and sequelae. These are divided into extra and intracranial, the first being the most common, but less lethal. Among the extracranial are: labyrinthine fistula, subperiosteal abscess, mastoiditis, temporozigomatic abscess, Bezold's abscess, parapharyngeal abscess, facial palsy, petrositis and labyrinthitis. Among the intracranial are: meningitis, epidural abscess, subdural empyema, brain abscess, the sigmoid sinus thrombophlebitis and otological hydrocephalus. The aim of this study is to identify the main complications of otitis media, distinguishing them from the incidence, degree of morbidity and mortality and analyze the development, management and treatment required for each entity. Brain abscess is the most common entity and subperiosteal abscess is the most common extracranial complication. Labyrinthine fistula occurs most often related to OMC. This has the physiopathology erosion of the bone covering the semicircular canal, usually the lateral semicircular canal. Labyrinthitis results from the spread of infection from the cochlear window membrane and can be presented in two ways: serous or suppurative labyrinthitis. The most common intracranial complication is meningitis, rarely associated with cholesteatoma and most often associated with AOM, of higher incidence in children. CT with contrast is the gold standard when you suspect any complications in patients with otitis media after undergoing a thorough history and physical examination. When the physician knows the possible complications and their signs and symptoms, the diagnosis is early and the prognosis best. Treatment of complications in general is based on patient hospitalization, myringotomy with culture and sensitivity, intravenous antibiotic therapy as early as possible and mastoidectomy in all cases related to COM or recurrent complications.