Complications of chronic otitis media and their management: a study at tertiary care centre

Background: Chronic otitis media is a disease associated with complications. Due to ignorance, poor literacy and late presentation the management becomes challenging and difficult. The aim is to find the incidence of complications of COM and their management. Methods: This is a hospital based observational study carried out on 50 patients with COM admitted in the Department of Otorhinolaryngology of a tertiary care centre during a period of 1 year. Results: Out of 50 patients, 19 cases of safe COM and 31 of unsafe COM. 31% of safe COM patients had complications with 100% extracranial complication (mastoiditis). 45% of unsafe COM had complications, where most common extracranial complication was mastoiditis and intracranial complication was brain abscess. Complications were more common in the age group of 21-30 years. In all the patients, multiple intravenous antibiotics were given covering gram positive, gram negative and anaerobic organisms. The intracranial complications were initially managed by neurosurgery or neurology followed by disease eradication at source. 2 mortalities were seen in cases with intracranial complication due to late presentation. Conclusions: The complications of COM still pose a great challenge. Late presentation leads to difficulty in management and consequently higher mortality. This study mainly emphasizes the importance of early diagnosis and prompt treatment to avoid complications.