Otalgia natural history
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S[2]
Overview
Natural history
- Otitis media: The course of the disease is benign with most of the patients recovering without any sequelae.
- Otitis externa: Disease course is benign except in Diabetic patients who may experience Malignant otitis externa caused by Pseudomonas bacteria.
Prognosis
- Otitis media:
- Prognosis is excellent.
- Intra-cranial and intra-temporal complications occur in less than 1% patients.
- Otitis media in infants younger than 12 months predisposes to long-term speech and language problems.
- It has also been reported to negatively affect pre-existing cognitive or language problems warranting careful follow-up and early referral.
- Otitis externa:
- Prognosis is good. Swimmers can return to routine aquatic activities in less than a week.
- Worse prognosis is seen in some Diabetic patients in whom it may progress to Malignant otitis externa.
- Mastoiditis:
- Prognosis of Acute Mastoiditis is good as far as facial nerve, vestibule and intra-cranial structures are not involved. Recovery is complete from Surgical mastoiditis.
Complications
- Otitis media can be complicated by the development of:
- Otitis externa can be complicated by the development of:
- Necrotizing otitis externa
- Mastoiditis
- Chondritis of the auricle
- Bony erosion of the base of the skull
- Central nervous system (CNS) infection
- Mastoiditis can be complicated by the development of:
- Hearing loss
- Facial nerve paralysis
- Osteomyelitis
- Periostitis
- Intra cranial complications - Meningitis, Cerebral abscess, Epidural abscess, Subdural empyema
- Labyrinthitis
- Sigmoid sinus thrombosis
- Abscess formation