Surgical Management of Intracranial Complications of Otogenic Infection

Bento, Ricardo E.; Brito, Rubens de; Ribas, Guilherme Carvalhal

doi:10.1177/014556130608500111

Cited by 29 publications

(15 citation statements)

References 11 publications

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“…In cases of more substantial defects, an effective method of treating damage has involved the use of the fascia with the additional strength of the pedicle muscle flap. These described reconstruction methods correspond to worldwide reports in this field [12,13]. With large defects, reconstruction can also be carried out using the cartilage from the tragus or the bone lamella (eg, from the wall of the maxillary sinus) to strengthen the reconstruction between the fascia and the pedicle flap of the temporal muscle.…”

Section: Discussionsupporting

confidence: 53%

“…The least advanced changes in the middle ear are observed in the cases of simple chronic otitis media. Other types of chronic infection in the middle ear, and in particular those accompanied by the presence of inflammatory granulation or cholesteatomatous pathology, are characterized by bone erosion observed in the middle ear, which, apart from hearing impairment due to ossicular chain destruction, may lead to otogenic complications [1,2]. …”

Section: Introductionmentioning

confidence: 99%

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Bony wall damage in the region of the middle and posterior cranial fossa observed during otosurgery

et al. 2012

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SummaryBackgroundBony wall damages in the region of the middle and posterior cranial fossa are usually observed in cases of chronic otitis media. These defects can also be congenital, post-traumatic, iatrogenic or due to tumors. They can potentially lead to the development of intracranial complications.Material/MethodsWe analyzed patients who were diagnosed as having bony wall damage in the region of the middle and/or posterior cranial fossa. We also discuss methods of reconstruction during otosurgery.The analysis involves patients who underwent middle ear operations in the Department of Otolaryngology at the Jagiellonian University of Krakow between 2004 and 2008; 495 otosurgeries were performed during this period of time.ResultsIn 70% of patients the reason for otosurgery was chronic otitis media. In 20%, bone defects occurred simultaneously with otosclerosis. Less than 10% underwent otosurgery for other reasons. Bony wall damage in the region of the middle and posterior cranial fossa were diagnosed in 46 patients who underwent surgery. In patients with bony wall damage, otogenic intracranial complications were described in 14 cases.ConclusionsThe performed reconstruction methods for bony wall damage, which used the fascia, strengthened with the pedicle muscle flap for larger defects and with either bone lamella or cartilage in specific cases, proved successful.Nearly 80% of bony wall damages in the region of the middle and posterior cranial fossa remain asymptomatic and are discovered incidentally during middle ear surgery. The above observations emphasize the significant role of pre-operative imaging diagnostics.

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Section: Discussionsupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Bony wall damage in the region of the middle and posterior cranial fossa observed during otosurgery

et al. 2012

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“…Intracranial complications can be classified under meningitis, lateral sinus thrombophlebitis, otitic hydrocephalus, extradural abscess, subdural abscess, and brain abscess subheadings. [32] The diagnosis of otitis media complications is made based on the examination and, if necessary, CT examination. [33] Parenteral antibiotics are the first option in the treatment of acute mastoiditis and petrositis.…”

Section: Complications Of Otitismentioning

confidence: 99%

“…In other non-meningitis intracranial complications, the recommendations of the neurosurgery unit should be followed and mastoidectomy should be considered, when the patient's overall condition is improved. [32] During the pandemic, when a patient with suspected otitis complications visits the outpatient clinic, examination should be done with PPE after questioning a cough, shortness of breath, or contact history with a COVID-19-positive patient. [14] Endoscope can be used, as otomicroscopic examination would be difficult with a face shield/goggles.…”

Section: Complications Of Otitismentioning

confidence: 99%

Approach to otolaryngology emergency in COVID-19 pandemic

Çomoğlu¹

2020

tr-ent

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Since the first case of novel coronavirus disease (COVID-19) was reported in China on December 31 st , 2019, it spread almost all over the world rapidly and was declared pandemic by the World Health Organization (WHO) on March 11 th , 2020. The first case in Turkey was also reported on the same day. COVID-19 is mainly transmitted through droplets and infected individuals may remain asymptomatic. As the reservoir of the virus is the upper respiratory tract, otolaryngology (ENT) examinations carry a high risk of infection to the physician and fever, sore throat, cough, shortness of breath and general illness, which are frequent COVID-19 symptoms, can be also seen in various ENT diseases. In case of severe upper respiratory obstruction, unstoppable nasal bleeding, or septal hematoma, which should be promptly intervened as ENT emergencies during the pandemic, patients should be accepted as COVID-19-positive and intervened accordingly. Thus, personal protective equipment (PPE) with eye protection/goggles, face shield, bonnet, disposable protective drape, and FFP3/N99 mask, if available and FF2/N95, if not must be used. In cases where the procedure can be postponed for some time, patients such as nasal fracture, and otitis-sinusitis complications should be requested polymerase chain reaction (PCR) for COVID-19 exclusion and thoracic section should be included in the computed tomography examination, if required. If possible, it is recommended to use powered air purifying respirators in surgical procedures to the upper respiratory tract. In case of sudden hearing loss and facial paralysis, systemic steroid therapy should be avoided due to its immunosuppressive effects.

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“…Ubytek na kanale nerwu VII oraz na kanale półkolistym bocznym obserwowany był w grupie pacjentów z ubytkami podstawy czaszki tak często, jak u wszystkich chorych operowanych na ucho środkowe. W całej populacji operowanych z powodu schorzeń ucha środkowego bezwzględna częstość występowania ubytków kanału nerwu twarzowego i kanału półkolistego poziomego jest zatem większa niż częstość występowania ubytków podstawy czaszki [9][10][11].…”

Section: Omówienieunclassified

Uszkodzenia ścian kostnych ucha środkowego u chorych operowanych z powodu schorzeń ucha w Klinice Otolaryngologii CM UJ w latach 2008–2012

Boroń

Wiatr

Przeklasa

et al. 2014

Otolaryngologia Polska

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Background: We perform the middle ear operation to remove pathological tissue and in the next step present ossicular chain reconstruction. Otosurgeon has to also identify bone dehiscences, as a potential way to develop otogenic intracranial and intratemporal complications. Aim: We analyzed the patients with bone defects in the middle and/or posterior cranial fossa who present also defects of the bony wall of the facial nerve canal and lateral semicircular canal. Material and methods: We observed 537 patients who were operated on middle ear for the first time in the Department of Otolaryngology at the Jagiellonian University of Cracow from 2008 to 2012. We used a special questionnaire that includes diagnostics of the ear's disease, method of the operation and short-and long-term effects. Results: We discuss 45 patients with the skull base defects in the middle and/or posterior cranial fossa. Dehiscence of the bony wall of the facial nerve canal was present in 7 patients. In 4 cases semicircular canal fistula coexisted.The most common cause of bone dehiscence was granulation tissue, less frequently cholesteatoma. Conclusions:1. Apart from skull base defects in the middle and/or posterior cranial fossa, frequency of bony dehiscence of the facial nerve and semicircular canal fistula is the same as in all population operated on ear.2. Defects of the bony wall of the facial nerve and semicircular canal fistula are observed more frequently in granulomatous chronic otitis media than in cholesteatoma chronic otitis media.3. We observe the same frequency of intracranial complication in population of patients with defects of the bony wall of the facial nerve canal and horizontal semicircular canal than in all groups with skull base defects.

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Surgical Management of Intracranial Complications of Otogenic Infection

Cited by 29 publications

References 11 publications

Bony wall damage in the region of the middle and posterior cranial fossa observed during otosurgery

Bony wall damage in the region of the middle and posterior cranial fossa observed during otosurgery

Approach to otolaryngology emergency in COVID-19 pandemic

Uszkodzenia ścian kostnych ucha środkowego u chorych operowanych z powodu schorzeń ucha w Klinice Otolaryngologii CM UJ w latach 2008–2012

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