Pediatric otitis media complications

1 - Description:

Otitis media complications are the spread of middle ear and mastoid infection beyond the pneumonitised spaces in the temporal bone and the mucosa lining these spaces following acute otitis media or chronic otitis media infections. Complications are divided into intratemporal, extratemporal and intracranial. Acute mastoiditis is the most common complication, spreading extratemporally and causing subperiosteal abscesses. Meningitis is the most common intracranial complication. There are still new algorithms being developed in terms of radiological imaging, surgical and medical treatments in the management of complications. Therefore, a session on otitis complications and their management would be useful.

2 - Outcome Objectives:

·      To address cases presenting with different clinical symptoms

·      Preferred imaging methods in otitis complications

·      Explain the timing of radiological imaging

·      To define appropriate surgical treatments according to the type of otitis complication

·      To reveal the agents supported as medical treatment

3 - Structure of the Session:

·      Definition, formation mechanisms, and classification of otitis complications

·      Clinical symptoms, findings, and radiological imaging algorithms used in diagnosis

·      Surgical and medical algorithms appropriate for the type of otitis complication

·      Case examples

·      Summary

4-Background:

·      TUTAR HAKAN,DÜZLÜ MEHMET,GÖKSU NEBİL,ÜSTÜN BEZGİN SELİN,BAYAZIT YILDIRIM AHMET (2013). Audiological correlates of tumor parameters in acoustic neuromas. European Archives of Oto-Rhino-Laryngology, 270(2), 437-441., Doi: 10.1007/s00405-012-1954-2

·      ÇAKABAY TALİYE,ÜSTÜN BEZGİN SELİN,TARAKÇIOĞLU MAHMUT CEM,KOÇYİĞT MURAT,SERİN  KESKİNEĞE BİLGE,GİRAN ÖRTEKİN SAFİYE,ÖZDEMİR MUSTAFA (2019). Why do infants pull their ears?. Auris Nasus Larynx, 46(5), 803-807., Doi: 10.1016/j.anl.2019.02.009

·      KARAMERT RECEP,DÜZLÜ MEHMET,TUTAR HAKAN,ERAVCI FAKIH CİHAT,TÜRKCAN ALPER KUTALMI ,ZORLU MEHMET EKREM,U UR MEHMET BİROL,CEBECİ SÜLEYMAN,ÜSTÜN  BEZGİN SELİ N,CEVİZCİ RAŞİT,BAYAZIT YILDIRIM AHMET (2019). Assessment of Cochlear Implant Revision Surgeries in a Cohort of 802 Patients. OTOLOGY NEUROTOLOGY, 40(4), 464-470., Doi: 10.1097/MAO.0000000000002152

·      ÜSTÜN  BEZGiN  SELiN,UYGUR  KADiR  KEMAL,GÖKDOĞAN  ÇAĞIL,ELMAS ÇİĞDEM,GÖKTAŞ GÜLESER (2019). The Effects of Riluzole on Cisplatin-induced Ototoxicity. International Archives of Otorhinolaryngology, 23(3), 267-275., Doi: 10.1055/s-0038-1676654

Olfaction in children, disorders, diagnosisi and treatment is presented

Foreign bodies of the esophagus in children still represent one of the emergency situations in ENT. They are most common between the ages of 2 and 7. These can be a wide variety of objects that a child swallows by right or involuntarily. Most often, these are metal coins and parts of toys, and less often pieces of food.

the paper presents a retrospective analysis of 83 rigid esophagoscopies that were performed in the ENT clinic of the UKC RS banjaluka in a fifteen-year period (2009-2024), and due to suspicion of a foreign body in the esophagus in patients with an average age of about 3.38 years. The diagnosis was made on the basis of heteroanamnesis, clinical picture, clinical ENT examination, lung x-ray, EGD x-ray, and rigid esophagoscopy, which was also a therapeutic method. The leading symptom in the largest number of cases (62) was dysphagia. The most frequently extracted foreign body was a metal foreign body with rounded edges (coins) localized at the height of the first physiological constriction. In all patients, a rigid esophagoscopy was performed under general endotracheal anesthesia, and after esophagoscopy and foreign body extraction, antibiotic therapy was prescribed, and in 10%, corticosteroid therapy. Out of the total number of esophagoscopies, we had complications in 4 patients in the form of a lesion of the back wall of the esophagus.

esophageal foreign bodies in children still represent one of the emergency situations in ENT, and they require special attention because they are mostly young children. For classic

esophagoscopy, endoscopic instruments and a skilled endoscopist are necessary, because after all, we are talking about small children with a delicate and narrow lumen of the esophagus, so the very attempt to remove a foreign body means a possible danger for mucosal lesions, which can lead to more serious consequences.The prevention of aspiration of foreign bodies in the esophagus in children is important and must be continuous, and includes education of parents, especially in the first two years of life by pediatricians and family medicine doctors.

This session is designed to equip the attendee with a broad understanding of the principles of using navigation systems for both anterior and lateral skull base surgery in children. There is very little experience globally in the use of navigation for paediatric anterior skull base surgery and none in paediatric lateral skull base surgery therefore this will be a novel session for attendees to learn about the benefits and limitations of this technology, as well as hints and common pitfalls in it’s use in children. The session will consist of presentations by a leading paediatric anterior skull base surgeon and leading paediatric lateral skull base surgeon with extensive experience of navigation systems in this population group. There will then be a panel discussion and an opportunity for attendees to gain practical experience with the navigation system.

the objectives are:

• understanding of the indications of use of the navigation system in paediatric anterior and lateral skull base surgery.

• understanding of how to set up the navigation system in the paediatric population for both anterior and lateral skull base surgery.

• appreciation of tips in using this technology in the paediatric population and common pitfalls.

• potential future uses of this technology.

the session presenters will be ms grace khong (consultant in paediatric rhinology and anterior skull base surgery) and mr sunil sharma (consultant in paediatric otology and lateral skull base surgery). The key references demonstrating the presenters’ experience in this topic are:

• davies t, zammit m, todd h, sharma r, khong g. Elective paediatric functional endoscopic sinus surgery: a tertiary centre experience. J laryngol otol. 2025 aug 1:1-5. Doi: 10.1017/s0022215125102922. Epub ahead of print. PMID: 40746304.

• milinis k, thompson n, atsmoni SC, sharma SD. Sinogenic intracranial suppuration in children: systematic review and meta-analysis. Otolaryngol head neck surg. 2022 aug;167(2):215-223. Doi: 10.1177/01945998211043847. Epub 2021 sep 7. PMID: 34491863.

• salem j, bakundukize j, milinis k, sharma SD. Mastoid obliteration versus canal wall down or canal wall up mastoidectomy for cholesteatoma: systematic review and meta-analysis. Am j otolaryngol. 2023 mar-apr;44(2):103751. Doi: 10.1016/j.Amjoto.2022.103751. Epub 2022 dec 27. PMID: 36586321.

• sharma SD, kumar g, bal j, eweiss a. Endoscopic repair of cerebrospinal fluid rhinorrhoea. Eur ann otorhinolaryngol head neck dis. 2016 jun;133(3):187-90. Doi: 10.1016/j.Anorl.2015.05.010. Epub 2016 jan 6. PMID: 26776882.

• milinis k, thiagarajan j, leong s, de s, sinha a, sharma r, sharma s. Review of management practices of sinogenic intracranial abscesses in children. J laryngol otol. 2023 oct;137(10):1135-1140. Doi: 10.1017/s0022215123000166. Epub 2023 feb 8. PMID: 36751894.

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I am working as an Audiology and Speech Pathology Specialist (PhD) at Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Ear, Nose and Throat Department. My primary area of ​​work is the rehabilitation process of voice disorders, but I also work in swallowing rehabilitation. I have made scientific contributions in congresses such as Voice Istanbul, UEP, National Laryngology Congresses in the past years as a panel and scientific study. If you, my esteemed professors, deem it appropriate, I will be honored to take part in this beautiful congress. Best regards.

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