Transtemporal approach to otogenic brain abscesses
| Autor: | Chris Coulson, Richard M. Irving, Ausama Alaani, Ann L. McDermott |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Brain Abscess Mastoidectomy Ear disease Mastoid Central nervous system disease otorhinolaryngologic diseases medicine Humans Child Cholesteatoma Brain abscess Retrospective Studies Cerebrospinal Fluid Otorrhea Petrous Apex business.industry Temporal Bone Retrospective cohort study General Medicine Middle Aged medicine.disease Anti-Bacterial Agents Surgery Otitis Media medicine.anatomical_structure Otorhinolaryngology Posterior cranial fossa Child Preschool Drainage Female Otologic Surgical Procedures business |
| Zdroj: | Acta Oto-Laryngologica. 130:1214-1219 |
| ISSN: | 1651-2251 0001-6489 |
| DOI: | 10.3109/00016481003749321 |
| Popis: | The standard current treatment of an otogenic brain abscess is drainage via neurosurgical burr hole or complete excision, followed by an otological procedure to eradicate the primary pathology – often at a later date. We describe the drainage of otogenic brain abscess via a transtemporal approach. We present a retrospective study of six cases, five children and one adult. All the children had acute middle ear disease while the adult patient had a petrous apex cholesteatoma. All cases had an otogenic intracranial abscess either in the posterior cranial fossa or in both posterior and middle cranial fossae. Diagnosis was confirmed by computed axial tomography (CT) scan. All the patients were treated by mastoidectomy and needle aspiration to drain the abscesses. In all cases the brain abscess and the ear pathology were successfully treated by a single stage transmastoid approach. The five paediatric patients had an extended cortical mastoidectomy approach to both intracranial pathology and ear disease except one patient who required a burr hole to drain a posteriorly located subdural posterior fossa abscess. The adult patient underwent petrosectomy, followed by transtemporal abscess drainage. There was postoperative pus recollection in one patient who required further aspiration. We conclude that transtemporal drainage of an otogenic brain abscess can successfully treat otological and intracranial pathology in a single operation. It has a low complication rate and avoids the need for a craniotomy or subsequent operations. |
| Databáze: | OpenAIRE |
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