Complications of Acute and Chronic Otitis Media in a Tertiary Referral Center in Nepal

Objective: The aim of this study was to report the incidence of complications in otitis media and to determine the frequencies of various extracranial and intracranial complications at a tertiary care hospital. Methods: We retrospectively reviewed the clinical records of patients of all ages and genders who were treated in a tertiary care hospital in Nepal from May 2015 to May 2020 for complications of acute and chronic otitis media. The complications were broadly classified as extracranial and intracranial. The details of patient profiles, histories, examination findings, investigations and treatments were reviewed from the charts. Results: The mean age of 164 patients with complications of otitis media was 47.44 +/- 18.58 years. There were 79 (48.2%) male and 85 (51.8%) female patients. The overall incidence of otitis media complications was 0.78%. The incidences of the complications from acute otitis media, chronic otitis media without cholesteatoma, and chronic otitis media with cholesteatoma were 0.5%, 0.06% and 5.6%, respectively. Extracranial complications, intracranial complications and combined extracranial and intracranial complications were seen in 80%, 11% and 9% of the patients, respectively. The most common extracranial and intracranial complications were subperiosteal abscesses and brain abscesses, respectively. There was one mortality due to complication. Conclusion: The incidences of complications and mortality from otitis media have declined with the availability of suitable antibiotics, improved imaging, and multidisciplinary management. Antibiotic resistance and masking of signs and symptoms, however, could pose challenges in the future.