INTRATEMPORAL COMPLICATIONS OF ACUTE OTITIS-MEDIA IN INFANTS AND CHILDREN

We reviewed our experience with 100 children admitted to Children's Ho spital of Pittsburgh between 1980 and 1995 with an intratemporal compl ication of acute otitis media. Seventy-two patients were treated for a cute mastoiditis. Of these 72 children, 54 (75.0%) were treated Conser vatively with broad-spectrum intravenous antibiotics and myringotomy. Eighteen (25.0%) required mastoidectomy for treatment of a subperioste al or Bezold's abscess or cholesteatoma, or because of poor response t o conservative therapy. Twenty-two children presented with facial para lysis, complete in 5 (22.7%) and incomplete in 17 (77.3%). Eighteen (8 1.8%) were treated conservatively, but four required mastoid surgery, Nineteen patients had adequate follow-up; of these, 15 recovered norma l facial function but 4 were left with partial paralysis. Three patien ts presented with serous labyrinthitis and recovered completely with c onservative therapy. Of the two patients who presented with suppurativ e labyrinthitis, one was treated conservatively, but the other require d tympanomastoidectomy with cochleotomy; both patients had permanent, profound sensorineural hearing loss in the affected ear, Four patients presented with acute petrositis, and in all four it resolved with mas toidectomy, In the antibiotic era, intratemporal complications of acut e otitis media still occur in otherwise healthy children, often after inadequate treatment of acute otitis media.