Djeritsh D, Stojichitsh G, Radulovitsh R, Djordjevitsh Z, Arsovitsh N, Stefanovitsh D
Department of Otorhinolaringology and Maxillofacial Surgery, Belgrade.
Srp Arh Celok Lek. 1995 Nov-Dec;123(11-12):304-7.
The authors report the 20-year experience in the diagnosis and treatment of patients with otogenic brain abscess. In the studies were included 36 patients of whom 24 had a cerebral abscess and 12 a cerebell abscess. The otogenic brain abscess was usually associated with meningitis (45%). Headache and temperature were common with otogenic intracranial complications. The active chronic otitis with cholesteatoma was usually found in the middle ear. The inflammatory process was usually spread in the endocranial space through destroyed walls of the midle ear. Computerized tomography (CT) is the most safe method in the diagnosis of brain abscess, by which it is possible to localyze the abscess, to plan the operation and follow-up the success of treatment. Neurological and ophthalmological examinations cannot always detect brain abscess. The authors suggest that in cases of brain abscess, it is important to neurosurgically remove the abscess. After improvement of the general condition of the patient, otosurgical procedure must be done. In this group of patients mortality is relatively high, both in abscessus cerebri (20%) and abscessus cerebelli (25%).
作者报告了20年来耳源性脑脓肿患者的诊断和治疗经验。研究纳入了36例患者，其中24例患有脑脓肿，12例患有小脑脓肿。耳源性脑脓肿通常与脑膜炎相关（45%）。头痛和发热是耳源性颅内并发症的常见症状。活动性慢性胆脂瘤性中耳炎通常见于中耳。炎症过程通常通过中耳破坏的壁向颅内间隙扩散。计算机断层扫描（CT）是诊断脑脓肿最安全的方法，通过它可以定位脓肿、规划手术并跟踪治疗效果。神经学和眼科检查并不总能检测到脑脓肿。作者建议，对于脑脓肿病例，神经外科手术切除脓肿很重要。在患者一般状况改善后，必须进行耳外科手术。在这组患者中，脑脓肿（20%）和小脑脓肿（25%）的死亡率相对较高。
