MANAGEMENT OF OTOGENIC BRAIN ABSCESS
AbstractBackground: The relationship between otitis media and intracranial disease has long been established. Intracranialcomplications from Otitis Media can be quite devastating to the patient if an early diagnosis is not made. Brain abscessis one of the most dreadful complications of middle ear disease. The epidemiological presentation, clinical featuresand results of treatment are discussed in this study. Methods: This is a two years’ prospective study of 20 cases ofotogenic brain abscess carried out at PGM I, LRH Peshawar. The data on history and management of these patientswere collected and are reported. Results: There were 12 (60%) males and 6 (40%) females with a ratio of 3:2. Majorityof the patients were teenagers; however, the age range was from 5 to 40 years. Chronic suppurative otitis media wasthe main cause of otogenic brain abscesses. The commonest site was cerebellum. The commonest organism isolatedwas proteus (20%) followed by anaerobes (15%) and pseudomonas (10%). The commonest organism reported fromear discharge was also proteus. CT scan of the brain with contrast was the investigation on which further managementwas based. Burr-hole aspiration was the main neurological procedure adapted in this study. There was no neurologicaldeficit and epilepsy post operatively. Repeated aspiration was sometimes needed and recurrence was a problem (15%).Radical mastoidectomy was performed to eradicate focus of infection and make the ear safe (95%). The mortality was10% in this study.
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