Intratemporal and intracranial complications of acute suppurative otitis media in children: renewed interest.

In recent years, a rise in the incidence of intratemporal and intracranial complications of acute otitis media (AOM) has been mentioned in the literature. Lack of a well-developed immune system and difficulties in diagnosing AOM, can account for part of the rise in the incidence of complications of purulent middle ear infections in young children. Antibiotic treatment of AOM is certainly not an absolute safeguard against the development of complications. Antibiotic therapy may have a masking effect on significant signs and symptoms of complications, causing delay in diagnosis. Myringotomy, especially in young children, should not be forgotten for drainage and to provide material for culture. Increased virulence of the causative pathogens cannot be ruled out, but to date there is no evidence suggesting it. We have to maintain a high level of clinical awareness. If there is insufficient improvement of the patient with the appropriate conservative treatment, radioimaging followed by the necessary surgical procedures should be performed.