[Clinical analysis of extracranial and intracranial complications of cholesteatoma otitis media].

Abstract

To study the clinical feature of extracranial and intracranial complications caused by cholesteatoma otitis media.
A retrospective study as made of 78 patients with extracranial and intracranial complications caused by suppurative otitis media between January 1992 and December 2002 was conducted.
Fifty-six of the 78 patients had one complication and the other 22 patients had two or more complications among them. In this series, 24 cases had facial paralysis, 16 cases with suppurative labyrinthitis, 12 cases with meningitis, 11 cases with periauricular abscess, 9 cases with extradural abscess, 9 case with otogenic meningitis brain abscess, 6 case with lesion of sigmoid sinus and 5 cases with Bezold abscess. Of the 24 patients with facial paralysis, 15 with continued nerves had obtained omatomic preservation of the facial nerves, The nerve function of 11 patients recovered from House-Brackmann grade IV to grade II, the rest 4 patients didn't regain after operation. Four of the 9 patients with their facial nerves broken received anastomosis of the facial nerves, three cases received transplantation of the nervus auricularis magnus, and two received anastomosis to nervus auricularis magnus. The nerve function recovered from House-Brackmann grade V - IV to grade III.
Even though the incidence of the complications has been low down in past years, there are still some serious complications. Temporal bone CT scan plays an important role in the diagnosis of extracranial and intracranial complications of cholesteatoma otitis media. The most reliable method to diagnosis and treat the complications is surgery.