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Intracranial spread of chronic middle ear suppuration
Siba P Dubey1, Varqa Larawin, Charles P Molumi
1Department of Ear, Nose and Throat, Port Moresby General Hospital, Papua New Guinea. dubeysp@datec.net.pg
American Journal of Otolaryngology
|December 18, 2009
Summary
Intracranial complications from chronic middle ear infections are serious, with otitic meningitis being most common. Delayed treatment worsens prognosis, highlighting the need for prompt intervention and management of infected sinus thrombi.
Area of Science:
- Otolaryngology
- Neurosurgery
- Infectious Diseases
Background:
- Chronic middle ear suppuration can lead to severe intracranial complications.
- Understanding the pathogenesis and management outcomes is crucial for patient prognosis.
Purpose of the Study:
- To review the pathogenesis of intracranial complications arising from chronic middle ear infections.
- To analyze the management strategies and outcomes for these complications.
Main Methods:
- Retrospective review of 32 patient charts with intracranial complications due to chronic otitis media (1993-2007).
- Analysis of patient demographics, symptoms, clinical findings, and medical/surgical interventions.
Main Results:
- Otitic meningitis (43.7%) was the most frequent complication, followed by lateral sinus thrombosis (31.2%) and epidural abscess (21.8%).
- Multiple intracranial complications occurred in 43.7% of patients.
- The overall mortality rate was 31.2%.
Conclusions:
- Delayed presentation significantly worsens prognosis due to extensive intracranial infection.
- Surgical intervention, including removal of infected dural venous sinus thrombi, is essential to prevent septic emboli dissemination.
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