{Reference Type}: Journal Article
{Title}: Intratemporal and intracranial complications of acute otitis media in a pediatric population.
{Author}: Mattos JL;Colman KL;Casselbrant ML;Chi DH;
{Journal}: Int J Pediatr Otorhinolaryngol
{Volume}: 78
{Issue}: 12
{Year}: Dec 2014
{Factor}: 1.626
{DOI}: 10.1016/j.ijporl.2014.09.032
{Abstract}: <B>OBJECTIVE: </B>To review all cases intratemporal and intracranial complications of acute otitis media (AOM) in infants and children from 1998 to 2013.<BR><B>METHODS: </B>Retrospective chart review of 109 consecutive patients admitted for complications of AOM during a 15-year period at a tertiary-care children's hospital. The main outcomes are: (1) complications of AOM, (2) bacteriology, (3) management strategies.<BR><B>RESULTS: </B>In our population, complications included mastoiditis (86.1%), subperiosteal abscess (38%), facial nerve palsy (16.7%), sigmoid sinus thrombosis (8.3%) and epidural abscess (7.4%). Other complications included post-auricular cellulitis, otic hydrocephalus and elevated intracranial pressure, internal jugular thrombosis, cranial nerve VI palsy and Gradenigo's syndrome, labyrinthine fistula, sensorineural hearing loss, and cerebellar infarct. Sixty-one patients (56%) received antibiotics prior to presentation. Cultures revealed Streptococcus pneumoniae in 36 patients (33.3%), other bacteria in 30 patients (27.8%), and "no growth" in 33 patients (30.5%). Nine patients (8.3%) did not undergo culture. Of the patients with S. pneumoniae, 20 cultures (55%) were found to be multidrug-resistant. Eleven patients (10.2%) were treated non-surgically, 31 (31%) were treated with myringotomy and intravenous antibiotics. Forty patients (97.5%) presenting with subperiosteal abscess required mastoid surgery. Thirteen of 18 (72.2%) patients with facial paralysis had full recovery. Eight of 10 (80%) patients with epidural abscess empyema required mastoid surgery and incision and drainage of the abscess.<BR><B>CONCLUSIONS: </B>Complications of AOM are uncommon, yet continue to have potentially serious consequences. The bacteriology in this population reveals an increasing trend of multi-drug resistant S. pneumoniae as the causative organism.