ISSN 1308-7649 | E-ISSN 2148-3817
Original Article
Otogenic Intracranial Abscesses, Our Experience Over the Last Four Decades
1 Department of Allergy, University of Helsinki and Helsinki University Hospital, Finland  
2 Department of Otorhinolaryngology, University of Helsinki and Helsinki University Hospital, Finland  
3 Department of Radiology, HUS Medical Imaging Centre, University of Helsinki and Helsinki University Hospital, Finland  
4 Pikkujätti Medical Centre for Children and Youth, Finland  
5 Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Töölö Hospital, Finland  
J Int Adv Otol ; : -
DOI: 10.5152/iao.2016.2758
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Key Words: Intracranial abscess, otitis, otogenic, complication
Abstract

OBJECTIVE: To evaluate the predisposing factors for otogenic intracranial abscesses, assess their changes over time, and analyze how they differ from those due to other causes.

 

MATERIALS and METHODS: The medical records of all patients treated for otogenic intracranial abscesses, between 1970 and 2012 at a tertiary referral center, were retrospectively analyzed. The analysis included patient demographics, clinical characteristics, causative pathogens, treatments, outcomes, and comparisons of otogenic and non-otogenic intracranial abscesses.

 

RESULTS: Of all intracranial abscesses, 11% (n=18) were otogenic. In the 1970s, otogenic infections were a common predisposing factor for intracranial abscess; but within our study period, the incidence of otogenic intracranial abscesses decreased. Most (94%) otogenic cases were due to chronic suppurative otitis media and 78% were associated with cholesteatoma. Most patients (94%) had ear symptoms. The most common presenting symptoms were discharge from the infected ear (50%), headache (39%), neurological symptoms (28%), and fever (17%). The most common pathogens belonged to Streptococcus spp. (33%), Gram-negative enteric bacteria (22%), and Bacteroides spp. (11%). Neurosurgery was performed on all patients, 69% of which were prior to a later ear surgery. Surgery of the affected ear was performed on 14 patients (78%). A favorable recovery was typical (78%); however, one patient died.

 

 

CONCLUSION: Otogenic intracranial abscesses were most commonly due to a chronic ear infection with cholesteatoma. Ear symptoms and Gram-negative enteric bacteria were more common among patients with otogenic than non-otogenic intracranial abscesses.

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