A review of 50 cases of intracranial complications from otogenic infection between 1961 and 1977

Abstract

The records of 50 patients with intracranial complications of middle ear disease treated over the past 16 years have been reviewed. Virtually all the known intracranial consequences of middle ear infection have been encountered, and include cerebral abscess, cerebellar abscess, meningitis, lateral sinus thrombosis, otitic hydrocephalus and cortical thrombophlebitis. The clinical features, neurological signs and investigative data for each group have been compared and contrasted. Treatment in the past has consisted of radical and modified radical mastoidectomy. It is proposed that these techniques will continue to be preferred for the management of chronic otitis media in the presence of a condition as serious as an intracranial complication. It is concluded that with a quoted incidence of postoperative cholesteatoma as high as 40% intact canal wall techniques are not justified in these patients at present.

Current trends in the management of the complications of chronic otitis media with cholesteatoma

“…Historically, the most common complication of LST was septic emboli with hip, ankle, knee and shoulder joint involvement [65]. Today the procedure is only indicated for specific reasons: when the clot extends beyond the mastoid area; persisting septicemia and pulmonary complications despite initial treatment with surgery and antibiotics; and infection or thrombosis of the IJV [51,63]. Today the procedure is only indicated for specific reasons: when the clot extends beyond the mastoid area; persisting septicemia and pulmonary complications despite initial treatment with surgery and antibiotics; and infection or thrombosis of the IJV [51,63].…”

Isolated Lateral Sinus Thrombosis

“…14 Our series of isolated LST differs from previous large series, which were collected in ear, nose, and throat departments 6 -8,15-18 where LST most frequently occurred as a complication of otitis media or other local infection. 7,8,[15][16][17][18][19][20][21] The typical pattern was that of patients with an old or recent history of discharging ears who had neglected otitis media and presented with retroauricular swelling, otorrhea, fever, headache, nausea, and vomiting. In old series, patients were treated by internal jugular vein ligation 19,20 and, in more recent ones, by antibiotics and eventually surgery.…”

Clinical Signs, Magnetic Resonance Imaging Features, and Outcome After Surgical and Medical Treatment of Otogenic Intracranial Infection in 11 Cats and 4 Dogs

“…Results of numerous studies indicate significant morbidity and mortality associated with intracranial complications of middle and inner ear disease in people before the advent of antibiotics in the early 1960s. [11][12][13][14] The development of new and effective antibiotics and advances in diagnostic imaging technology have dramatically reduced the incidence of otogenic intracranial infection in people as well as the morbidity and mortality associated with them. [15][16][17][18][19][20][21] Acute infections generally develop more frequently in infants and young children and are more likely to lead to meningitis.…”