Objective:The purpose of this study was to determine the factors that are important for the early diagnosis of intracranial and intratemporal complications of otitis media.Study design:The study design was a retrospective follow-up study.Setting:The study took place at a tertiary referral center.Patients:The medical history of 23 patients with intracranial and intratemporal complications of otitis media was analyzed.Interventions:Diagnostic and therapeutic procedures were performed.Main Outcome Measures:Age, initial diagnosis, final diagnosis, early presenting symptoms, otoscopic findings, time interval between the first manifestation of symptoms and the start of therapy, and follow-up status were measured.Results:In almost all patients, early symptoms included persisting fever and headache. High morbidity and mortality were correlated to a prolonged time interval between the early symptomatology and start of treatment. Doctor's delay was regarded as the most significant delaying factor.Conclusion:Early diagnosis of otogenic complications of otitis media based on the early symptoms persisting fever and headache can reduce morbidity and mortality associated with these complications.