Radical mastoidectomy: its place in otitic intracranial complications

Singh, Bhugwan; Maharaj, Tejprakash Jugpershad

doi:10.1017/s0022215100125435

Cited by 100 publications

(92 citation statements)

References 20 publications

(50 reference statements)

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“…The decision for the choice of surgical technique is of particular importance to preserve a higher hearing rate and prevent complications such as infection, cerebral hernia, recurrence, and treatment failure [2,3]. Imaging of the temporal bone, with CT and magnetic resonance imaging (MRI), is playing an increasingly important role for diagnosis, surgical decision, and follow up.…”

Section: Introductionmentioning

confidence: 99%

An Evaluation of Preoperative Computed Tomography on Patients with Chronic Otitis Media

Yildirim-Baylan¹,

Özmen²,

Gün³

et al. 2011

Indian J Otolaryngol Head Neck Surg

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This study aimed to compare the veracity of computed tomography findings on patients undergoing surgery for chronic otitis media (COM) with the surgical findings, and to determine to what extent the preoperative computerized tomography (CT) findings are useful to the surgeon. A series of 56 patients with COM undergoing preoperative CT scanning followed by surgical exploration of the middle ear and mastoid. Operative notes were recorded and data collected on the nature of soft tissue masses, the status of the ossicles, presence or absence of facial canal dehiscence and semicircular canal (SCC) dehiscence and the presence or absence of dural plate erosion, and sigmoid sinus thrombosis. Fifty-six patients were recruited in the study, 30 males and 26 females. The age range was from 16 to 67 years with a mean of 26.51 ± 1.4 years. The preoperative CT scan imaging in cases of cholesteatoma, ossicular chain erosion and SCC dehiscence have good correlation with the intraoperative findings. The specificity of preoperative CT scan in detecting facial canal dehiscence, dural plate erosion and sigmoid sinus thrombosis in patient of COM were weak.Preoperative computed tomography evaluation is fairly useful especially in cases of cholesteatoma. According to the results of this study, CT is of value particularly in the definition of cholesteatoma, and in determining ossicular chain erosion and semicircular canal fistula.

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Section: Introductionmentioning

confidence: 99%

An Evaluation of Preoperative Computed Tomography on Patients with Chronic Otitis Media

Yildirim-Baylan¹,

Özmen²,

Gün³

et al. 2011

Indian J Otolaryngol Head Neck Surg

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“…Thus, currently, surgical drainage of the abscess via a radical mastoidectomy, canal wall up mastoidectomy or craniotomy, remains the treatment of choice [10]. The use of canal wall up mastoidectomy appears to be an acceptable alternative to radical mastoidectomy, with no significant difference in the mortality or morbidity between the two techniques [10,16]. Some suggest that the main indication for the latter technique is a cholesteatomatous ear [16].…”

Section: Discussionmentioning

confidence: 99%

“…The use of canal wall up mastoidectomy appears to be an acceptable alternative to radical mastoidectomy, with no significant difference in the mortality or morbidity between the two techniques [10,16]. Some suggest that the main indication for the latter technique is a cholesteatomatous ear [16]. A craniotomy performed concurrently with a mastoidectomy treats both the source of the infection and its complications and has been shown to be safe [17].…”

Section: Discussionmentioning

confidence: 99%

Otogenic Intracranial Abscesses: A Case Series

Rs¹,

Baxter²,

Kf³

et al. 2013

JCR

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Abstract:Objective: To aid clinicians in the early identification of life-threatening otogenic intracranial abscesses(OIA) through recognition of signs and symptoms.Setting: Tertiary referral centre in Melbourne, Australia. Subjects and Methods:5 patients, aged 6-31, with otogenic intracranial abscesses, were identified with ICD-10 diagnostic codes. Charts were reviewed for history, examination, investigations, treatment and outcomes.Results: Headache was the most common presenting symptom (5 of 5 patients), followed by fever (present in 4 of 5 patients), seizures (3 of 5 patients) and confusion (3 of 5 patients). Nausea with vomiting was seen in 2 patients, so was ear discharge. One patient developed complete left-sided facial nerve palsy with disdiadochokinesia and vertigo.Conclusion: An OIA is a life-threatening condition requiring aggressive surgical and antibiotic therapy. Acute or chronic otitis media can lead to OIA, and the diagnosis should be considered in all such patients presenting with a headache, fever, seizures and confusion, especially after failing conservative treatment.

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“…Conventional approach was to drain the abscess through a burr hole and some time through a craniotomy with abscess excision. Once the patient's condition stabilized, the source of infection has to be eradicated through a radical mastoidectomy [8,9]. Unfortunately, this approach is causing trauma to healthy brain tissue and spreading the infection to healthy brain areas [9,10].…”

Section: Introductionmentioning

confidence: 99%

“…Once the patient's condition stabilized, the source of infection has to be eradicated through a radical mastoidectomy [8,9]. Unfortunately, this approach is causing trauma to healthy brain tissue and spreading the infection to healthy brain areas [9,10]. Alternate approach is to drain their abscess through the radical mastoid cavity following the route of infection using aspiration technique.…”

Section: Introductionmentioning

confidence: 99%

Single-Stage Trans-mastoid Drainage of Otogenic Brain Abscess: A Single-Institution Experience

Mukherjee

Das

Paul³

2016

Indian J Otolaryngol Head Neck Surg

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Brain abscess is the ultimate otogenic complication, both in severity and difficulty of management. In developing countries with high incidence of cholesteatoma, brain abscess is not a rare complication. In India, brain abscesses constitute about 8 % of all intracranial lesions. The surgical treatment of brain abscess is very controversial. This prospective study was done in ENT department of a tertiary care hospital in Kolkata, during the period from May 2009 to April 2014. 22 such cases of otogenic brain abscess managed by single-stage trans-mastoid drainage along with meticulous mastoid clearance. On the basis of clinical, radiological and operative findings, data of all patients with otogenic brain abscess were analyzed. There was male predominance and 9 (40.91 %) of them were younger than 20 years. 15 (68.18 %) cases were of cerebellar abscess and in 7 (31.82 %) cases were of the temporal abscess. Lateral sinus thrombosis was the most common associated complication found (22.73 %) in our study. All the patients peri-operatively revealed cholesteatoma. All the patients recovered well and there was no recurrence of symptoms on a minimum 15 months followup. This approach suits the otologists in clearing the cause and effect of pathology, at the same sitting. This singlestage approach decreases the peri-operative morbidity and mortality of the two-stage procedure. It also decreases the hospital stay and financial burden.

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Radical mastoidectomy: its place in otitic intracranial complications

Cited by 100 publications

References 20 publications

An Evaluation of Preoperative Computed Tomography on Patients with Chronic Otitis Media

An Evaluation of Preoperative Computed Tomography on Patients with Chronic Otitis Media

Otogenic Intracranial Abscesses: A Case Series

Single-Stage Trans-mastoid Drainage of Otogenic Brain Abscess: A Single-Institution Experience

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