Browning G G
J Laryngol Otol. 1984 Jan;98(1):23-6. doi: 10.1017/s0022215100146122.
Active chronic otitis media affects 0.5 per cent of adults and has two main variants. The first is when there is a squamous epithelial retraction pocket or cholesteatoma. The second variant is when the disease is primarily of the mucosa of the middle ear and mastoid air-cell system. Classically a cholesteatoma is considered 'unsafe' because of the risk of complications, particularly intracranial infection. Mucosal disease, on the other hand, is considered 'safe' because complications are thought to be rare. Surgery in the form of a modified radical mastoidectomy is considered to make active chronic otitis media 'safe'. A retrospective review of 26 consecutive brain abscesses considered secondary to active chronic otitis media revealed that a cholesteatoma was present in 12 (46 per cent), mucosal disease in 10 (38 per cent) and a modified radical mastoidectomy had been performed in four (15 per cent). Mucosal disease and a modified radical mastoidectomy should no longer be considered 'safe'. However, the risk of developing an intracranial abscess from any type of active chronic otitis media is low, in the region of one in 3,500.
慢性化脓性中耳炎影响0.5%的成年人，有两种主要类型。第一种是存在鳞状上皮退缩袋或胆脂瘤。第二种类型是疾病主要累及中耳和乳突气房系统的黏膜。传统上，胆脂瘤因有并发症风险，特别是颅内感染风险，被认为是“不安全的”。另一方面，黏膜疾病被认为是“安全的”，因为其并发症被认为很少见。改良乳突根治术形式的手术被认为可使慢性化脓性中耳炎“安全”。一项对26例连续的、被认为继发于慢性化脓性中耳炎的脑脓肿的回顾性研究显示，12例（46%）存在胆脂瘤，10例（38%）为黏膜疾病，4例（15%）已进行改良乳突根治术。黏膜疾病和改良乳突根治术不应再被认为是“安全的”。然而，任何类型的慢性化脓性中耳炎发生颅内脓肿的风险都很低，约为3500分之一。
