The early signs and symptoms of neurotologic complications of chronic suppurative otitis media.

The delay in the diagnosis of neurotologic complications of chronic suppurative otitis media has been explained in a number of ways, including antibiotic suppression, surgical drainage, and a lowered index of clinical suspicion because the problem is relatively rare today. Twelve cases of neurotologic complications of chronic suppurative otitis media were reviewed to determine the early and late findings that should raise the physician's index of suspicion. Purulent, malodorous drainage, headache, and fever were the significant early findings. Altered mental status was a late finding, and usually indicated established intracranial infection. By drawing attention to the early findings, we hope to lower the morbidity and mortality associated with these complications.