Otitis Media Extratemporal Complication

Introduction: The negligence in middle-ear chronic infections without significant symptomatology may result in devastating complications, irreversible sequelae, or even death. Although subperiosteal abscess is a common complication of otitis media, parotitis and abscess of the temporozygomatic are rarely found. Comorbidities and neglect to the treatment are variables related to the onset of complications.

Objective: Reporting a rare case of otitis media extratemporal complication.

Resumed report: J.J.S.S., 39 years old, male, alcohol consumer, smoker, hypertensive (uncontrolled), diabetic (decompensated), with bilateral chronic otitis media, complained about pain and progressive volume increase of right-side retro-, infra-, and pre-auricular regions for 20 days. Physical examination revealed bulging, hyperemia, hyperthermia, auricle dislocation to front and down, fluctuation areas, and necrosis. Edema and ipsilateral periorbital hyperemia were also found. The computed tomography of temporal bones showed thickening of the soft tissue of the parotid region and right auricle, with signs of obliteration of the homolateral external auditory canal and suggested bilateral mastoid sclerosis. The patient was submitted to surgical drain. The following treatment was based on antibiotics (ciprofloxacin and oxacilin), anti-inflammatory drug (ketoprofen), insulin therapy, and daily curatives. This case corresponds to a coalescence of three otitis media extratemporal complication forms: subperiosteal, temporozygomatic, and parotid abscesses. In this situation, surgical intervention for draining is mandatory.

Conclusion: The patient's recurrent neglect (regarding his comorbidities and chronic otitis media’s treatment) caused vulnerability to the development of complications. The satisfactory clinical evolution demonstrates the efficacy of surgery treatment.