الفهرس 
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Abstract
Acute and chronic suppurative otitis media are very common diseases that should be carefully treated, as serious complications could develop. Despite the significantly decreased incidence of suppurative otitis media-related complications since the introduction of antibiotics, this clinical problem has not been eliminated.
Suppurative otitis media remains a serious concern, and its complications could be life-threatening, with significant morbidity and mortality, particularly in developing countries and socioeconomically poor regions. So, the ultimate goal of our study was to screen complicated cases of suppurative otitis media whether acute or chronic types in our locality, with discussion of their demographic aspects, to pay attention to the magnitude of this problem.
Our study was carried out on 53 patients with different clinical forms of complications due to acute and chronic suppurative otitis media admitted to ENT department at Sohag University hospital within the duration between April, 2017 and April, 2020.
All patients were subjected to complete history taking, general examination, full ENT examination with special concern to ear examination in order to define post auricular swelling, mastoid fistula, tenderness on mastoid process, tympanic memberane characters, ear discharge, aural polyp, or cholesteatoma. Intra operative microscopic examination was done to determine cholesteatoma, granulation tissue, polyp, bone erosion, state of ossicles, and facial nerve integrity and evidence of complications. Full radiologic and audiological investigations were also done for every patient to define site and extent of complications.
With reference to demographic data of studied patients, their ages ranged from 3 months to 75 years with a mean of 19 years, the majority of patients (32) were children. Twenty eight out of 53 patients were males and 25 were females.
As regard classification of complications, 17 patients presented with acute suppurative otitis media and 36 patients presented with chronic suppurative otitis media (26 of them were cholesteatomatous and 10 were non cholesteatomatous). Most of patients (47 out of 53 patients) presented with extra-cranial complications, 4 patients presented with intracranial complications and two patients presented with both extra and intracranial complications.
With reference to clinical presentation of complications, mastoid complications were the commonest including mastoid abscess in 18 cases, mastoiditis in 7 cases, antral abscess in 7 cases, meatomastoid fistula in 5 cases and mastoid fistula in 3 cases. The next complication was facial palsy in 9 cases; followed by brain abscesses (temporal lobe & cerebellar) in 4 cases, 3 temporal and 1 cerebellar then lateral sinus thrombophlebitis in 2 cases, labrynthine fistula in 2 cases, and lastely labrynthitis in 1 case.
Conclusion
from this study we could conclude that:
1.Otitis media and its complications remains too high prevalent pathology in a developing country like Egypt (particularly Upper Egypt) in spite of modern antibiotics therapy.
2.The incidence of complications due to chronic otitis media with cholesteatoma is higher compared to that of acute otitis media and chronic otitis media without cholesteatoma. Extracranial complications are much common compared to intracranial complications.
3.Factors as younger age and male gender were associated with increased incidence of otitis media complications.
Recomendation
1.Longer follow-up duration with larger sample size and other ethnic groups in further studies are needed for accurate documentation of otitis media and its complications.
2.There is a need for better knowledge of the illness among primary care practitioner and junior ENT residents, better ear care, good access to health facilities and screening program (based on clinical features, CT scan and culture sensitivity and early intervention) for early detection and management of such conditions.
3.It is critical that clinicians (especially pediatricians, family doctors and general practitioners) remain alert for clinical signs and symptoms that may indicate the onset of these potentially serious complications and be prepared to examine patients for the presence of more than one complication.