Evolution in Management of Otogenic Brain Abscess

Szyfter, Witold; Kruk-Zagajewska, A; Borucki, Łukasz; Bartochowska, Anna

doi:10.1097/mao.0b013e3182488007

Cited by 22 publications

(19 citation statements)

References 5 publications

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“…Children were a clear minority [5] , only presenting at the beginning of the study period. In the 1970s, otogenic infections were a common predisposing factor for intracranial abscess formation and 25% of all IAs were otogenic [15] .…”

Section: Discussionmentioning

confidence: 99%

“…Intracranial abscess formation may follow acute otitis media (AOM), but is more commonly associated with chronic suppurative otitis media (CSOM) [2,[5][6][7] . The development of more effective treatments for AOM and its complications has resulted in fewer chronic ear problems, at least in the developed countries [3,5,[8][9][10][11][12] . The incidence of otogenic IAs has been decreasing [13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

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Otogenic Intracranial Abscesses, Our Experience Over the Last Four Decades

Laulajainen‐Hongisto¹,

Aarnisalo

Lempinen³

et al. 2017

Int Adv Otol

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OBJECTIVE:To evaluate the predisposing factors for otogenic intracranial abscesses, assess their changes over time, and analyze how they differ from those due to other causes. MATERIALS and METHODS:The medical records of all patients treated for otogenic intracranial abscesses, between 1970 and 2012 at a tertiary referral center, were retrospectively analyzed. The analysis included patient demographics, clinical characteristics, causative pathogens, treatments, outcomes, and comparisons of otogenic and non-otogenic intracranial abscesses. RESULTS:Of all intracranial abscesses, 11% (n=18) were otogenic. In the 1970s, otogenic infections were a common predisposing factor for intracranial abscess; but within our study period, the incidence of otogenic intracranial abscesses decreased. Most (94%) otogenic cases were due to chronic suppurative otitis media and 78% were associated with cholesteatoma. Most patients (94%) had ear symptoms. The most common presenting symptoms were discharge from the infected ear (50%), headache (39%), neurological symptoms (28%), and fever (17%). The most common pathogens belonged to Streptococcus spp. (33%), Gram-negative enteric bacteria (22%), and Bacteroides spp. (11%). Neurosurgery was performed on all patients, 69% of which were prior to a later ear surgery. Surgery of the affected ear was performed on 14 patients (78%). A favorable recovery was typical (78%); however, one patient died. CONCLUSION:Otogenic intracranial abscesses were most commonly due to a chronic ear infection with cholesteatoma. Ear symptoms and Gram-negative enteric bacteria were more common among patients with otogenic than non-otogenic intracranial abscesses.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Otogenic Intracranial Abscesses, Our Experience Over the Last Four Decades

Laulajainen‐Hongisto¹,

Aarnisalo

Lempinen³

et al. 2017

Int Adv Otol

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“…In the present study, any age can be affected but most commonly the age of disease presentation was second decade (34.1%) followed by first decades (26.8%) [15]. While in age group of 31-40 years, 41-50 years and 51-60 years were also affected with number of patients were 12(14.6%), 11(13.4%) and 09 (10.9%) respectively.…”

Section: Age Distributionmentioning

confidence: 48%

Otogenic abscess: rarity and reality

Kale

Chhabria

Sharma

et al. 2020

Trop j ophthalmol otolaryngol

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Introduction: Otogenic abscess is a complication commonly arising from active squamous chronic otitis media. It is rare (1:10000) but in fact are a dangerous reality to be managed promptly. Materials and Methods: A retrospective study of 82 cases of otogenic abscesses were studied over a period 24 years by simple random sampling. Cases of ear malignancy, previously operated mastoidectomy were excluded from study. All postop cases were analysed. Result: Most commonly affected were male (63.4%) in the second decade (34.1%) of life. Commonest bacterial infection was staphylococcus aureus (31.7%). Conclusion: Otogenic abscess though rare, are a reality and should be suspected when the patient with chronic ear discharge has high grade fever, severe headache and does not respond to best medical line of treatment. All these patients were subjected to imaging neurosurgical I&D of brain abscess followed by canal wall down tympano-mastoidectomy.

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“…Szyfter et al showed that chronic inflammation of the middle ear with cholesteatoma and/or granulation and not its acute stage contributed to 100 of 103 patients with otogenic brain abscess. 10 Patients in rural areas, many of whom are void of secondary and tertiary education, have poor insight into their condition and depend on traditional or herbal remedies for treatment. As a result, they may only consult a qualified medical practitioner as a last resort.…”

Section: Discussionmentioning

confidence: 99%

Intracranial Complications of Chronic Otitis Media: Why Does It Still Occur?

et al. 2019

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Intracranial complications secondary to chronic otitis media (COM) include otogenic brain abscess and sinus thrombosis. Intravenous antibiotics and imaging have significantly reduced the incidence of intracranial complications secondary to COM. However, the same does not apply to a developing country like Malaysia, which still experiences persisting otogenic complications. This case series describes 3 patients with COM and intracranial complications. All 3 patients had COM with mastoiditis, with 1 of the 3 having a cholesteatoma. Postulated reasons for the continued occurrence include poor access to health care, poor compliance with medication, and the lack of pneumococcal vaccination during childhood. In conclusion, public awareness and a timely specialty referral can reduce the incidence of intracranial complications of COM.

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Evolution in Management of Otogenic Brain Abscess

Cited by 22 publications

References 5 publications

Otogenic Intracranial Abscesses, Our Experience Over the Last Four Decades

Otogenic Intracranial Abscesses, Our Experience Over the Last Four Decades

Otogenic abscess: rarity and reality

Intracranial Complications of Chronic Otitis Media: Why Does It Still Occur?

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