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Check the Ear. The Importance of Ear Examinations in Assessment of Intracranial Subdural Empyema
Joseph Yoon1, Michael Redmond2
1Department of Neurosurgery, Royal Darwin Hospital, Darwin Northern Territory, Tiwi 0810, Australia. joseph.yoon@nt.gov.au.
Abstract:
Intracranial subdural empyema (ISE) is an uncommon condition previously associated with almost 100% morbidity and mortality. Since the introduction of antibiotics and advancements in diagnosis the complication rates have significantly improved. We report an unusual case of a 32-year-old Aboriginal male diagnosed with ISE. On closer inspection the ISE was found to be a complication of otitis media with a cotton bud lodged in the external acoustic meatus. The report provides a literature review on the relationships of ISE, otitis media and foreign bodies. We conclude that although rare, all patients with suspected ISE should undergo an ear examination as it is at no cost to the patient or health service but may be the difference between life and death.
Insights
Intracranial subdural empyema (ISE) is rare but serious. A case highlights otitis media and a foreign body as a cause, emphasizing the need for ear exams in suspected ISE cases.
Area of Science:
- Neurology
- Otolaryngology
- Infectious Diseases
Background:
- Intracranial subdural empyema (ISE) is a rare intracranial infection.
- Historically, ISE had high morbidity and mortality rates, but antibiotics have improved outcomes.
- Otitis media and external ear canal foreign bodies are potential, though uncommon, causes of ISE.
Purpose of the Study:
- To report an unusual case of ISE secondary to otitis media with a foreign body.
- To review the literature on the association between ISE, otitis media, and foreign bodies.
- To emphasize the importance of ear examination in patients with suspected ISE.
Main Methods:
- Case report of a 32-year-old Aboriginal male with ISE.
- Literature review on ISE, otitis media, and foreign bodies.
- Clinical examination, including otoscopy.
Main Results:
- The patient was diagnosed with ISE.
- The ISE was found to be a complication of otitis media caused by a cotton bud in the external acoustic meatus.
- Literature review confirmed the rare but documented association between these conditions.
Conclusions:
- Although rare, otitis media with a foreign body can lead to ISE.
- Ear examination is a simple, cost-effective diagnostic step for suspected ISE.
- Prompt identification and management of ear pathology can be life-saving in suspected ISE cases.
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