ACUTE OTITIS-MEDIA - THE EVOLUTION OF SURGICAL-MANAGEMENT

Objective: Acute suppurative otitis media has been a common disease si nce time immemorial and, until the late nineteenth century, was follow ed by a high complication rate, major morbidity, and frequent mortalit y. Since then, the overall incidence of the disease has changed little ; however, in less than a century, progressively more sophisticated su rgery and the introduction of antimicrobials have reduced the mortalit y, at least in developed countries, to a rarity. Complications such as chronic perforation of the tympanic membrane or cholesteatoma, althou gh much less frequent than in the past, are not uncommon. The evolutio n of mastoid surgery into the antibiotic era is reviewed. Conclusion: There is concern that with the increasing frequency of bacterial resis tance to antibiotics and the decreasing familiarity of family practiti oners with the clinical presentation of complicated otitis media that we may be faced with a resurgence of mastoid disease.