Poststapedectomy otitis media and meningitis.

A patient developed acute otitis media, labyrinthitis, and meningitis 16 months after a stapedectomy operation, and 14 similar cases have been collected from the literature. Poststapedectomy otitis media carries an increased risk of labyrinthitis and meningitis and requires prompt antibiotic therapy and regular observation until cured. Should labyrinthitis occur, with or without meningitis, fistula repair must be undertaken as soon as the infection is eliminated. All stapedectomy patients require regular supervision, and must report for urgent treatment if symptoms of otitis media or perilymph fistula occur. Stapedectomy techniques should not employ sharp bevelled prostheses, and autogenous tissue grafts are probably superior to an absorbable gelatin sponge in protecting the inner ear. Eustachian tube problems and recurring or chronic upper-respiratory tract infections can predispose to middle ear infection and are thus contraindications to stapedectomy.