Intracranial abscesses associated with chronic suppurative otitis media

Area of Science:

• Otolaryngology
• Neurosurgery
• Infectious Diseases

Background:

• Intracranial abscesses are serious complications of chronic suppurative otitis media (COM).
• COM is a common ear infection that can lead to severe complications if left untreated.

Purpose of the Study:

• To investigate the incidence, types, clinical presentation, management, and outcomes of intracranial abscesses in patients with COM.
• To highlight the importance of early diagnosis and multidisciplinary management.

Main Methods:

• Retrospective study of 780 patients hospitalized for COM.
• Analysis of 32 patients diagnosed with intracranial abscesses.
• Review of clinical data, imaging studies, microbiological cultures, and treatment outcomes.

Main Results:

• 32 patients (4.1% of COM admissions) developed intracranial abscesses.
• Perisinus abscess was most common (13/32), followed by temporal lobe (8/32), epidural (7/32), cerebellar (6/32), and subdural empyema (2/32).
• Common symptoms included headache (93%), fever (87%), and altered mental status (62%). Most patients had cholesteatoma and bony defects. Gram-negative bacilli and anaerobes were prevalent. Three patients had neurological sequelae, and one died.

Conclusions:

• Intracranial abscesses are significant complications of COM requiring high clinical suspicion and advanced imaging for early detection.
• Effective management necessitates a coordinated, multidisciplinary approach involving otolaryngology, neurosurgery, and infectious disease specialists.
• Prompt diagnosis and treatment can improve outcomes and reduce morbidity and mortality associated with these severe infections.