Clinical Analysis Of 87 Cases Of Otogenic Intracranial And Extracranial Complications

Objective:to explore the clinical characteristics,as well as the diagnosis and treatment methods of 87 cases of the intracranial and extracranial otogenic complications in affiliated hospital of Zunyi medical university;to analyze the risk factors related to intracranial and extracranial otogenic complications;To study the predictive value of multifactor combination for retroauricular subperiosteal abscess and otogenic meningitis;and to increase people's knowledge on intracranial and extracranial otogenic complications,so as to provide reference for the diagnosis,treatment and prevention of intracranial and extracranial otogenic complications.Methods:790 cases of patients suffering from otitis media who were hospitalized for surgical treatment in affiliated hospital of Zunyi medical university from March 2010 to September 2018 were collected.A total of 87 cases(101cases)suffered from intracranial and extracranial otogenic complications.And retrospective analysis was conducted on their clinical data.Single factor and multiple factors Logistic regression analysis and the receiver-operating characteristic(ROC)curve analysis were made on the patients' general situation,pneumatolysis degree of mastoid process,duration of disease,development of external auditory canal,adenoid hypertrophy,whether suffer from sinusitis;and the independent risk factors for intracranial and extracranial otogenic complications were summarized.To explore the influence of relevant factors on otogenic intracranial and extracranial complications and its predictive value.Results:The incidence for the intracranial and extracranial complications among the patients who suffered from otitis media and went to this hospital was 11.01%.There were29 cases of intracranial complications in total.There were 72 cases of extracranial complications in total..The symptoms for patients suffering from intracranial and extracranial otogenic complications include headache,fever,pyorrhea in external auditorycanal,etc.Proteus is the most common pathogenic bacteria in bacterial culturing of the secretion.Taking pathological tissues was performed for 75 cases,in which,49 were cholesteatoma and 26 were inflammatory granulation tissue.For over 6-12 months of follow-up,75 cases of dry ear were realized,2 cases died,and 1 case became lost to follow-up after leaving hospital voluntarily.Monofactor analysis was carried out on the possible pathogenic factors of the 87 patients with otogenic complications: age(< 18 years old),living environment(countryside),good pneumatolysis of mastoid process,and stenosis or atresia of external auditory canal,were the risk factors(P < 0.05)for intracranial and extracranial otogenic complications.And monofactor and multivariate logistic regressive analysis was carried out on the possible pathogenic factors of the 31 patients with retroauricular subperiosteal abscess: age(< 5 years old),living environment(countryside),stenosis or atresia of external auditory canal,and good pneumatolysis of mastoid process,were the independent risk factors(P < 0.05)for causing retroauricular subperiosteal abscess.In the risk prediction model of retroauricular subperiosteal abscess,The area under the ROC curve was predicted to be 0.828 by the combination of the four indicators.In the risk prediction model of otogenic meningitis.The area under the ROC curve was predicted to be 0.838 by the combination of the three indicators.Conclusion:In this study,retroauricular subperiosteal abscess was the most common otogenic extracranial complication of otitis media,and otogenic intracranial complication was the most common otogenic meningitis.Proteus is the most common pathogenic bacteria in bacterial culturing of the secretion.The incidence of complications is high in minor and rural patients suffering from otitis media.The patients with stenosis of external auditory canal and good pneumatolysis of mastoid process are more likely to be found having otogenic complications.Age,living environment and development of external auditory canal are the independent risk factors for causing retroauricular subperiosteal abscess.Age,tympanic membrane and development of external auditory canal are independent risk factors for otogenic meningitis.In the diagnosis and treatment of suppurative otitis media mastoiditis,great attention should be paid to the early symptomsof intracranial otogenic complications and timely treatment should be given to prevent the occurrence of serious intracranial otogenic complications.