Otorhinological brain abscess therapy--past and present

In the past several years a concensus approach has been reached in diagnosis and therapy of brain abscess. The ease and accuracy of evaluation of intracranial lesions afforded by third generation computerized tomography scanners has lead to reliable, quick, non-surgical diagnoses and monitoring which is relatively non-invasive. The use of multiple agent, increased spectrum, antimicrobials has resulted in acceptable reduced morbidity and mortality. This has decreased the need for therapeutic surgical intervention. The non-surgical approach was preceded by several other modes of management which were acceptable in their time. During the past 21 years, 17 patients have been under the care of one or more of the above authors. A review of these cases is presented with instructive and informative histories. A knowledge of past therapeutic modalities and their attendant complications compared with present medical therapy assures an acceptance of the latter as the method of choice. A search of the general literature shows wide acceptance in other fields; however, no reference could be found in the recent otolaryngological literature to support a non-surgical approach.