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[Otogenic brain abscesses in children]
Z Szmeja1, A Kruk-Zagajewska, B Kulczyński
1Kliniki Otolaryngologicznej Katedry Chorób Ucha, Nosa, Gardła i Krtani AM, Poznaniu.
Insights
Otogenic brain abscesses, a complication of middle ear infections, were treated in 75 patients. Survival rates were high, especially for temporal lobe abscesses in children, with a 90% survival rate.
Area of Science:
- Otolaryngology
- Neurosurgery
- Infectious Diseases
Background:
- Otogenic brain abscesses are serious complications of middle ear infections.
- While not significantly increasing in recent years, they remain a concern in both pediatric and adult populations.
- Often arising from chronic otitis media with cholesteatoma, these abscesses require prompt and effective management.
Purpose of the Study:
- To analyze the incidence, characteristics, and treatment outcomes of otogenic brain abscesses.
- To evaluate survival rates based on abscess location and patient age.
- To describe the surgical management approach employed at the Department of Otolaryngology.
Main Methods:
- Retrospective review of 75 patients treated for otogenic brain abscesses between 1953 and 1989.
- Analysis of patient demographics, affected ear conditions (acute vs. chronic otitis media), abscess location, and side of involvement.
- Evaluation of treatment protocols, including surgical interventions and antibiotic use, and their correlation with patient survival.
Main Results:
- Temporal lobe abscesses were most common, with a higher incidence on the right side in children.
- Survival rates were favorable: 90% for temporal lobe abscesses in children, 75% for cerebellar abscesses in children, and approximately 80% for adults.
- The study observed no significant increase in cases over the last decade of the study period.
Conclusions:
- Otogenic brain abscesses, particularly those originating from chronic otitis media, necessitate aggressive surgical management.
- The described surgical approach involving radical ear surgery and direct abscess drainage yields high survival rates.
- Early diagnosis and appropriate treatment are crucial for favorable outcomes in patients with otogenic brain abscesses.
Abstract:
In the years 1953-1989 in the Department of Otolaryngology, Medical Academy in Poznań 75 patients were treated for otogenic brain abscesses, among them 19 were children. In the last ten years the number of cases of this complication was not increased significantly in children and adults. In 3 cases abscess was diagnosed in acute otitis media, in the remaining cases it was a complication of chronic otitis media with cholesteatoma. Brain abscesses were situated more frequently in the temporal lobe. In children they developed more frequently on the right side. The survival in temporal lobe abscesses in children was 90%, and in cerebellar abscesses 75%. In adults the survival rate was about 80% for both localizations. In the treatment of these otogenic complications wide radical operation on the middle ear or ++antro-mastoidectomy with exposure of the dura and simultaneous approach to the abscess from the postoperative ear cavity, with puncture of the abscess and replacement of its contents with normal saline with antibiotic is the routine method in the Department.