INTRACRANIAL COMPLICATIONS OF ACUTE AND CHRONIC OTITIS MEDIA IN CHILDREN

D. Zanetti, L.O. Redaelli De Zinis, N. Civiero, C. Casirati

Otorhinolaryngologic Clinic - University of Brescia (Italy)

CNS (Central Nervous System) involvement is still a potentially fatal, although rare, complication of otologic infections in children. Improper use of antibiotics and late recognition of neurologic signs and symptoms explains the high mortality rates even in the antibiotic era. The Authors review 6 cases of intracranial complications of acute (n=3) or chronic otitis media (n=3) in the pediatric age among 576 patients treated at the otorhinolaryngologic Clinic of the University of Brescia over a 10 years period. There were three lateral sinus thrombophlebitis (one with cavernous sinus thrombosis), one meningitis, one cerebellar abscess and 1 hydrocephalus.

All patients presented with purulent otorrhea in spite of antibiotic therapy, spiking fever and headache before the onset of neurologic signs. All children underwent a combined operation (canal wall down mastoidectomy + craniotomy) or a modified radical mastoidectomy alone. Every patient except one recovered with no long-term neurologic sequel.