- 作者：Silvana Pellegrini ; silvanapellegrini75@hotmail.com ; Marí ; a Emilia Gonzalez Macchi ; Patricia Alejandra Sommerfleck ; Patricia Cristina Berná ; ldez
- 关键词：Complicaciones ; Otitis media aguda ; Pará ; lisis facial ; Laberintitis
- 刊名：Acta Otorrinolaringol¨®gica Espa?ola
- 出版年：2012
- 出版时间：January-February, 2012
- 年：2012
- 卷：63
- 期：1
- 页码：21-25
- 全文大小：203 K
Background
To describe the clinical features of intratemporal complications of acute otitis media (AOM) in children, a retrospective study was carried out for two years.
Methods
We considered acute mastoiditis, presence of postauricular swelling, erythema and tenderness and anteroinferior displacement of the auricle; labyrinthitis, presence of vestibular symptoms (spontaneous nystagmus and ataxia with or without vomiting; and facial nerve palsy, absence or decreased motility in hemiface.
All children underwent otomicroscopy for evidence of coexistent or recent AOM. Cultures were obtained by tympanocentesis and myringotomy, drainage of subperiosteal abscess or from granulation tissue during tympanomastoidectomy.
Results
From January 2008 to December 2009, 17 patients fulfilled the entry criteria. Median age: 54.2 months. Of the 17 cases, 30 % were infants younger than twelve months and most were boys (70.6 % ).
8/17 were receiving antimicrobial treatment. Diagnoses included 9/17 (52.9 % ) acute mastoiditis, 7/17 (41.2 % ) labyrinthitis and 1/17 (5.9 % ) facial nerve palsy. Intracranial complications were present in 17.6 % . All required intravenous antimicrobial treatment. Myringotomy was performed in 16/17, drainage of subperiosteal abscess in 3/17 and tympanomastoidectomy in 2/17. Bacteriology was positive in 9/17 cases, isolating Streptococcus pyogenes (S. pyogenes) in 44 % of patients. Secuelaes: One unilateral sensorineural hearing loss.
Conclusions
Acute mastoiditis is the most common complication. Labyrinthitis was diagnosed in 41.2 % of cases. S. pyogenes was prevalent in these serious invasive infections in our area. Associated intracranial complications were present in 17.6 % cases. Resolution of AOM complications required surgical procedures in all cases (myringotomy, drainage of subperiosteal abscess or tympanomastoidectomy).