Abstract Otology 2000 A19-1

Daniela Soldati MD, Albert Mudry MD

ENT Department University Hospital CHUV CH-Lausanne

Objective: The aim of this study was to determine the origin and to evaluate the treatment applied to acute otitis media with labyrinthisation at our institution. Material and Methods: Between January and June 1997, and between January and June 1998, 16 cases of adults' acute otitis media with labyrinthisation were documented. The charts of the 16 patients were reviewed, and data about laboratory results, treatment, audiological evolution, and follow-up examinations were collected. Results: All patients suffered from acute otitis media, with a sensorineural hearing loss and a pathological otoscopy. We performed 11 mastoidectomies, whereas 5 patients only received conservative treatment; all the operated cases showed a good hearing improvement after surgery. Audiometrical improvement in non operated patients took much more time and was never as good as for operated patients. A viral origin (Influenza, Picorna, Coksakie virus) was confirmed in 25% of the cases by the serological tests done on these patients. Conclusion: We believe that mastoidectomy is the treatment of choice for a labyrinthisation complicating an acute otitis media. In the past two years, an unusual large number of adult patients with labyrinthisation of an acute otitis media was seen at our outpatient care unit: in the preeceding 10 years (1987-1996), only one case per year had been recensed. We therefore tried to understand the reasons for this remarquable increase of complicated otits media. A viral origin of the disease, rarely reported in the literature, must be suspected if efficient oral antibiotics don't help in preventing labyrinthitis.