Extracranial and intracranial complications of suppurative otitis media. report of 102 cases

Abstract

During the eight-year period, 1983–1990, 102 cases of intracranial (IC) and extracranial (EC) complications from 17 144 suppurative otitis media were reviewed. The prevalence of each complication was 0.24 and 0.45 per cent respectively. Facial paralysis, subperiosteal abscess and labynnthitis were the common complications among the EC group, while meningitis and brain abscess were common in the IC group. Twenty five per cent of the EC group and 44 per cent of the IC group had more than two complications. The reliable warning signs and symptoms for IC complications were fever, headache, earache, vestibular symptoms, meningeal signs and impairment of consciousness. Proteus spp., Pseudomonas aeuruginosa and Staphylococcus spp. were the commonest organisms isolated from both groups. Cholesteatoma and granulation/polyp in the middle earl mastoid were the major findings in both patient groups. Mortality rate in the IC group was 18.6 per cent. Morbidity rate in each group was 14.3 per cent (EC) and 27.9 per cent (IC) respectively. Epidemiological presentations, clinical features and the result of treatment are discussed.

Clinicopathological study of otogenic brain abscess

“…Regarding the number of otogenic brain abscesses in the brain the fi ndings of this study corroborates with that of the other workers [1,3,4]. Only 1 patients (6.25%) had multiple brain abscesses, rest of the cases had single brain abscess (Fig.…”

“…Signifi cant percentage of brain abscesses are of otogenic origin. Otogenic brain abscess almost always develop in the temporal lobe area [1,3,5] in or in the cerebellum region [2,7]. In childrens 25% of all brain [4,6,8] abscesses are otogenic, while in the adults the incidence of brain abscess is >50% due to chronic ear diseases.…”

“…Fistula test, was done in every cases. Neurological examinations were performed, consciousness, neck rigidity, Kernig's sign [1,4], cerebeller signs [3,7], cranial nerve examinations [1,3,8], muscle power and tone, planter refl ex and jerks, papillary reactions, nystagmus, opthalmoscopy, speech, gait, etc. were looked for.…”

Internal jugular vein thrombosis in a case of attico antral disease — a rare presentation in this modern antibiotic era

“…Lateral sinus thrombophlebitis accounts for approximately 20 percent of intracranial complications of Suppurative otitis media [2]. Initially the process is always preceded by the development of extra dural perisinus abscess.…”

Complicações intracranianas das otites médias crônicas supurativas em crianças

“…We know that duration of the disease, time of diagnosis and early intervention reduce the number of complications [1][2][3][4] . We should also consider the presence of cholesteatoma in about 60 to 70% of the studies in Thailand, [4][5][6][7] , which exceeds the American statistics of 27% cholesteatomas, a country in which antibiotic therapy and surgery are performed early, leading us to the conclusion that it may be the best option to prevent ICC [1][2][3] . In fact, our reality is somewhat different.…”