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Evolution in management of otogenic brain abscess
Witold Szyfter1, Aleksandra Kruk-Zagajewska, Lukasz Borucki
1ENT, Head Neck Oncological Surgery Department, Poznań University of Medical Sciences, Poland. otosk2@amp.edu.pl
Summary
Mortality rates for otogenic brain abscesses significantly decreased over time due to advancements in diagnostics and treatment. Neuronavigation is a valuable tool in managing these severe complications from middle ear inflammation.
Area of Science:
- Neurosurgery
- Otolaryngology
- Infectious Diseases
Background:
- Otogenic brain abscesses are severe complications of middle ear infections.
- Historically, these abscesses carried high mortality rates.
- Advancements in medical technology have impacted treatment outcomes.
Purpose of the Study:
- To evaluate therapeutic outcomes for 103 patients with otogenic brain abscesses.
- To analyze treatment results across three distinct time periods: 1953-1977, 1978-1989, and 1990-2011.
- To assess the role of neuronavigation in managing these abscesses.
Main Methods:
- Retrospective analysis of 103 patients diagnosed with cerebral abscess of otogenic origin.
- Evaluation of diagnostic and treatment strategies employed over different time frames.
- Analysis included mortality rates, abscess characteristics, complications, neurological status, and bacteriological findings.
Main Results:
- Mortality rates declined progressively from 35% (1953-1977) to 14% (1978-1989) and 3% (1990-2011).
- Abscesses were predominantly in the temporal lobe, stemming from chronic otitis media.
- High concordance was observed between ear and abscess cultures; neuronavigation proved supportive.
Conclusions:
- Otogenic brain abscesses remain a critical complication of middle ear inflammation.
- Despite evolving surgical techniques and antibiotics, core treatment principles persist.
- Neuronavigation is a significant aid in the management of otogenic brain abscesses.
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