Introduction:
Despite the advent of
antibiotics and
immunizations in the last century,
complications of
otitis media remain quite frequent, have high
morbidity and
mortality rates, and pose a challenge to the otorhinolaryngologist.
Objective:
To establish the annual
incidence of intratemporal
complications of
otitis media and prospectively evaluate
patients via an
analysis of epidemiologic and clinical aspects.
Methods:
Prospective,
observational study. Between February 2010 and January 2011,
patients admitted to a
tertiary care,
university-based
otology practice with
diagnosis of
otitis media and an associated intratemporal complication (ITC) were included in the study. The following data were evaluated age,
sex, type of ITC,
treatment, imaging tests findings, type and degree of
hearing loss, and clinical outcome. The overall
incidence of all
complications and of each complication individually was determined. Results A total of 1,816
patients were diagnosed with
otitis media. For 592 (33%) individuals, the
diagnosis was chronic
otitis media; for 1,224 (67%), the
diagnosis was acute
otitis media. ITCs of
otitis media were diagnosed in 15
patients; thus, the annual
incidence of intratemporal
complications was 0.8%. We identified 19 ITC
diagnoses in 15
patients (3
patients had more than one
diagnosis). Labyrinthine fistulae were diagnosed in 7 (36.8%) individuals,
mastoiditis in 5 (26.3%),
facial palsy in 4 (21.1%), and
labyrinthitis in 3 (15.8%).
Conclusion:
The
incidence of intratemporal
complications in
Brazil remains significant when compared with
developed countries. Chronic
otitis media with
cholesteatoma is the most frequent
etiology of intratemporal
complications. Labyrinthine
fistula is the most common intratemporal complication...