Kronik Otitis Media Komplikasyonlarının Tanı ve Tedavi Özellikleri
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Dosyalar
Tarih
2002
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Cilt Başlığı
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Antibiyotik kullanımının yaygınlaşması ile, otitis media komplikasyonları önemli oranda azalmıştır. Günümüzde otitis media komplikasyonlarının büyük çoğunluğunu kronik otitis medialar (KOM) oluşturmaktadır. Komplikasyonlu KOM'larda hastalığın seyrini, tanı ve tedavi özelliklerini belirlemek amacıyla bu çalışma yapılmıştır. Hastalar ve Yöntem: Kliniğimizde 1991-2001 tarihleri arasında komplikasyonlu KOM tanısı almış ve tedavi görmüş 32 olgunun kayıtları retrospektif olarak incelendi. Hastaların yaşı, cinsiyeti, komplikasyonları, predispozan faktörleri, başvuru semptomları, otoskopik muayene bulguları, radyolojik incelemeleri, odyolojik bulguları, tedavi yöntemleri, operasyon bulguları ve postoperatif komplikasyonları ayrıntılı olarak kaydedildi. Bulgular: Olguların 7'sinde (%21.9) intrakraniyal, 25'inde (%78.1) ekstrakraniyal komplikasyon görüldü. İntrakraniyal komplikasyonlardan menenjit (%12.5), ekstrakraniyal komplikasyonlardan ise mastoidit ve mastoid apse (%28.2) en sık komplikasyon olarak tespit edildi. Olguların 30'unda (%93.7) tam iyileşme, 1'inde (%3.1) postoperatif dönemde medikal tedavi ile düzelen menenjit görüldü. Beyin apseli bir olgu (%3.1) ameliyat sonrası kaybedildi. Sonuç: Günümüzde bilinçsiz antibiyotik kullanımı KOM komplikasyonlarının semptom ve bulgularını baskıladığından erken tanı ve cerrahi tedavide gecikmelere neden olabilmektedir. Dikkatli bir anamnez, fizik muayene ve görüntüleme yöntemlerinin etkin kullanımı komplikasyonlara bağlı morbidite ve mortaliteyi azaltacaktır. Cerrahi tedavide standart mastoidektomilerin dışında, otonörolojide ya da kafa kaidesinde deneyimli bir ekibin görev alması sonuçları olumlu yönde etkileyecektir.
Objectives: Otitis media complications have decreased with the common use of antibiotics. Nowadays, Chronic otitis media (COM) constitute majority of the otitis media complications. This study has been carried out in order to determine the diagnostic and treatment features of the illness and course of illness in the complications due to COM. Patients and Methods: The recording of 32 cases, who had been diagnosed as complicated COM and had been treated, were studied retrospectively. The ages, sexes, complications, predisposing factors, symptoms at admission, otoscopic, radiologic, audiologic and operation findings, treatment modalities and postoperative complications of the cases were recorded elaborately. Results: Seven of the cases (21.9%) had intracranial and 25 of the cases (78.1%) had extracranial complications. We found out that meningitis (12.5%) was the most common complication in intracranial complications, Mastoiditis and mastoid abcess (%28.2) was the most common complication in extracranial complications. Thirty (93.7%) of the cases recovered completely, 1(3.1%) of the cases had meningitis which recovered with medical treatment during postoperative period. One(3.1%) of the cases with brain abcess was lost posoperatively. Conclusion: The use of antibiotics unconsciously may delay early diagnosis and surgical interventions as they hide the symptoms and findings of COM complications. A careful history and examination and the use of scanning methods effectively will reduce morbidity and mortality of complications due to COM. The results will be affected positively when an experienced team in otoneurology and skull base surgery in surgical interventions except for the standart mastoidectomy.
Objectives: Otitis media complications have decreased with the common use of antibiotics. Nowadays, Chronic otitis media (COM) constitute majority of the otitis media complications. This study has been carried out in order to determine the diagnostic and treatment features of the illness and course of illness in the complications due to COM. Patients and Methods: The recording of 32 cases, who had been diagnosed as complicated COM and had been treated, were studied retrospectively. The ages, sexes, complications, predisposing factors, symptoms at admission, otoscopic, radiologic, audiologic and operation findings, treatment modalities and postoperative complications of the cases were recorded elaborately. Results: Seven of the cases (21.9%) had intracranial and 25 of the cases (78.1%) had extracranial complications. We found out that meningitis (12.5%) was the most common complication in intracranial complications, Mastoiditis and mastoid abcess (%28.2) was the most common complication in extracranial complications. Thirty (93.7%) of the cases recovered completely, 1(3.1%) of the cases had meningitis which recovered with medical treatment during postoperative period. One(3.1%) of the cases with brain abcess was lost posoperatively. Conclusion: The use of antibiotics unconsciously may delay early diagnosis and surgical interventions as they hide the symptoms and findings of COM complications. A careful history and examination and the use of scanning methods effectively will reduce morbidity and mortality of complications due to COM. The results will be affected positively when an experienced team in otoneurology and skull base surgery in surgical interventions except for the standart mastoidectomy.
Açıklama
Anahtar Kelimeler
kronik otitis media, komplikasyon, kolesteatom, intrakraniyal komplikasyon, ekstrakraniyal komplikasyon, menenjit, mastoid apse, beyin apsesi, chronic otitis media, complication, cholesteatoma, intracranial,, extraranial, menengitis, mastoid abcess, brain abcess
Kaynak
KBB-Forum
WoS Q Değeri
Scopus Q Değeri
Cilt
1
Sayı
1
Künye
Arbağ, H., Keleş, B., Uyar, Y., Öztürk, K., Ülkü, Ç. H., (2002). Kronik Otitis Media Komplikasyonlarının Tanı ve Tedavi Özellikleri. KBB-Forum, 1(1), 3-7.
