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Transtemporal approach to otogenic brain abscesses.

Ausama Alaani¹, Chris Coulson, Ann L McDermott

¹ENT Department, University Hospitals Birmingham, Birmingham Children Hospital, UK. alaani2@yahoo.com

Acta Oto-Laryngologica

|May 5, 2010

Summary

Transtemporal drainage effectively treats otogenic brain abscesses and ear pathology in a single operation. This minimally invasive approach avoids craniotomy and reduces complications for brain abscess treatment.

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Area of Science:

Neurosurgery
Otolaryngology
Infectious Disease

Background:

Otogenic brain abscesses typically require multi-stage surgical interventions.
Standard treatment involves neurosurgical drainage followed by otological procedures.

Observation:

A retrospective study of six patients (five children, one adult) with otogenic intracranial abscesses was conducted.
Patients presented with acute middle ear disease or petrous apex cholesteatoma.

Findings:

A single-stage transmastoid approach, including mastoidectomy and needle aspiration, successfully treated both the brain abscess and ear pathology in all cases.
The adult patient underwent petrosectomy with transtemporal drainage; one pediatric patient required an additional burr hole for a posterior fossa abscess.

Implications:

Transtemporal drainage offers a single-stage solution for otogenic brain abscesses, integrating otological and intracranial treatment.
This approach has a low complication rate and obviates the need for craniotomy or staged procedures.