Cerebral abscesses secondary to otorhinolaryngological infections. A study of 386 cases

A study is presented, of adjacent cerebral abscesses secondary to otorhinolaryngological infections. A total of 386 patients were included. According to frequency, and in relation to the adjacent septic focus the cerebral abscesses were classified as: otogenic--334 cases (86.5%); rhinogenic--47 cases (12.2%); tonsillary--5 cases (1.3%). These abscesses had similar characteristics: they occurred with the highest frequency in the second and the third decade of life, had a higher incidence in males, the otorhinolaryngologic infection had a chronic course with frequent recidives, propagation of the infection from the original focus occurred by continuity or through the venous system, and the clinical picture was marked by symptoms of local and general infection, by meningeal manifestation, and frequently by altered consciousness (somnolence, confusion). Surgical treatment, next to other therapeutic measures (administration of antibiotics, anti-inflammatory drugs, and intensive care) was aimed at improving the vital prognosis. The postoperative mortality was 23.8%. It was also aimed at increasing the functional recovery rate. Neuropsychical sequellae were noted in 54.9% of all cases. After surgery for the cerebral abscess attempts were made at removing the septic focus, preventing any additional risk of cerebral seeding.