[Drainage of otogenic brain abscess under imaging guidance]

To investigate the methods and results of imaging guided puncture and drainage in the treatment of otogenic brain abscess.

Reviewed and analyzed four cases of otogenic brain abscess treated by the technique of imaging guided puncture and drainage from May 2010 to October 2013, all of the four cases were male with age ranged from 21 years old to 59 years old, among whom three cases were under 25 years old. All patients had history of middle ear cholesteatoma and were found single brain abscess. Three cases were cerebrum abscess and one case was cerebellum abscess.

The three cases with temporal lobe abscess received skull puncture drainage drilling, and one case with cerebellar abscess used the mastoid cavity puncture drainage. Four cases were punctured successfully in one time with the assistance of image navigation, 6-15 ml of pus was drainged out. After imaging showed pus cavity closure, middle ear surgery was performed to thoroughly remove cholesteatoma. The pus bacteria was cultured, which found three cases infected with staphylococcus aureus, Streptococcus mitis and proteusbacillus vulgaris respectively. The imaging showed brain abscess closed after once puncture drainage, four cases were cured without complications. Postoperative follow-up of one year with good mastoid cavity epithelialization.

Image guidance assisted puncture can drainage brain abscess with accurate positioning, less trauma, short operation time, and high safety, which could be choosen for otogenic abscess patient.