Otogenic intracranial abscess

Concurrent craniotomy and mastoidectomy - Changing trends in a developing country

Mary Kurien, Anand Job, John Mathew, Mathew Chandy

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

Objectives: To evaluate (1) the clinical profile, treatment, and outcome of adult and pediatric patients presenting with intracranial abscess of otogenic origin and (2) the advantages of concurrent craniotomy and mastoidectomy. Design: A prospective case series. Setting: An academic tertiary referral center in India. Patients: Thirty-six patients clinically diagnosed as having intracranial abscess that was secondary to suppurative otitis media and confirmed by computed tomographic scanning. Intervention: Concurrent craniotomy and mastoidectomy. Results: Children were more commonly affected than adults, and there was a male preponderance. All patients had cholesteatoma at surgery, although one third of the children had only granulation tissue on otoscopy. More than two thirds of the patients in both the groups presented with more than one intracranial complication and definitive surgical intervention was done later than 24 hours. Meningitis was the most frequent intracranial complication, followed by cerebellar abscess. There was no significant intraoperative or postoperative morbidity, mortality, recurrence of intracranial complications, or residual neurological deficits. Three children (14%) showed evidence of recidivism cholesteatoma requiring revision surgery. Conclusions: In suppurative otitis media with intracranial complications, it is accepted practice to treat the neurosurgical complication first, followed by mastoidectomy at a later date after the patient has been stabilized. Craniotomy with concurrent mastoidectomy is not only safe, but it also removes the source of infection at the same time the complications are being treated, thus avoiding reinfection while the patient is awaiting the ear surgery. In addition, the treatment is completed with a single, shorter hospital stay, which is more economical for the patient.

Original languageEnglish
Pages (from-to)1353-1356
Number of pages4
JournalArchives of Otolaryngology - Head and Neck Surgery
Volume124
Issue number12
Publication statusPublished - 1998

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Craniotomy
Abscess
Developing Countries
Suppurative Otitis Media
Cholesteatoma
Otoscopy
Granulation Tissue
Reoperation
Meningitis
Tertiary Care Centers
Ear
India
Length of Stay
Pediatrics
Morbidity
Recurrence
Mortality
Infection

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Otogenic intracranial abscess : Concurrent craniotomy and mastoidectomy - Changing trends in a developing country. / Kurien, Mary; Job, Anand; Mathew, John; Chandy, Mathew.

In: Archives of Otolaryngology - Head and Neck Surgery, Vol. 124, No. 12, 1998, p. 1353-1356.

Research output: Contribution to journalArticle

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