On the Treatment of Otogenic Brain Abscesses

Treatment of Nasal Polypi, With Comments on Frontal Sinus Surgery

“…The situation is then somewhat similar to that which occurs in the mastoid and aditus following cortical mastoidectomy. I have found that filling a cortical mastoidectomy cavity with a paste of plasma powder and penicillin solution (Harpman, 1950) leads to the operation cavity becoming filled with firm fibrous tissue which appears to resist reinfection. I am now filling large operated-on frontal sinuses with such a paste and trying to ascertain whether this is beneficial to firm and rapid healing.…”

The Treatment of Brain Abscess

“…The difficulties attending delay and the growing confidence in the power of penicillin to control infection have led some to practise the immediate radical excision of acute abscesses (Le Beau, 1946 ;Pennybacker and Sellors, 1948). Success has followed removal of pus, necrotic debris and doubtful brain tissue as early as six days after the probable onset (Pennybacker, 1948).…”

“…Although methods have differed, this policy of early attack has the support of Asherson (1948), Oliver and Leese (1949), Harpman (1950) and Mount (1950). Similar considerations have led me to aspirate the abscess as soon as the diagnosis is made, and though the initial exploration has twice proved fruitless, repetition a few days later has obtained ample pus at the same site.…”

“…This matter will be considered elsewhere, but meanwhile it may be remarked that thorotrast alone possesses the virtues of irascibility with all body fluids, of inertness in relation to penicillin and streptomycin, of phagocytosis by glial cells and of remaining in situ whilst providing suitable radiographic contrast. Its radioactivity is a serious disadvantage but no untoward effect seems to have followed its employment in this situation, although it has been widely used since its introduction by Kahn (1939).…”