Intracranial complications of CSOM in pediatric patients: A persisting problem in developing countries

Publication date: September 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 100
Author(s): Avani Jain, Nikhil Arora, Ravi Meher, J.C. Passey, Ramanuj Bansal
BackgroundIntracranial complications (ICC) of chronic suppurative otitis media (CSOM) occur even in the antibiotic area. These complications are commonly seen in pediatric patients due to poor hygiene and low immunity. They are more prevalent in developing countries due to illiteracy, low socioeconomic status and lack of access to health care facilities.ObjectiveTo study the incidence, clinical profile, treatment and outcome of pediatric patients presenting with intracranial complications of chronic suppurative otitis media.MethodsA retrospective analysis of intracranial complications of CSOM in pediatric patients was conducted over a period of 15 years at a tertiary level institute. Data regarding age, sex, clinical presentation, laboratory and radiological investigations, management, duration of hospitalization, and outcomes were recorded.ResultsThere were 142 patients, in the pediatric age group, diagnosed as having intracranial complications due to chronic otitis media during the study period. There was a decline in the incidence of ICC of CSOM. The most frequent intracranial complication seen was brain abscess (58.5%). All patients were administered intravenous antibiotics for 4–6 weeks and underwent canal wall down mastoidectomy. Neurosurgical intervention was considered in the required patients. The case fatality rate in our study was 2.8% (4 patients).ConclusionOtogenic intracranial complications can be fatal if not managed appropriately and timely. Broad spectrum intravenous antibiotics are usually required for 4–6 weeks with or without neurosurgical intervention and mastoid exploration. A high index of suspicion is required in all patients presenting with danger symptoms.



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