[The clinical presentation and management of otogenic intracranial disease (author's transl)].

Since the introduction of antibiotics in the treatment of ear infection the number of otogenic intracranial complications has decreased. Furthermore the clinical presentation of these complications has likewise since changed. The traditional symptoms and signs as mentioned in the literature are replaced by an indefinite inflammatory course, which is finally succeeded by rapid progress of the disease despite the use of antibiotics. Experiences with 22 patients are reported. Temporal lobe brain abscesses occurred in 11 patients, meningitis occurred in 3 others and lateral sinus thrombophlebitis occurred in 8, in 2 of whom meningitis also occurred. Five patients died as a result of the intracranial complication. After establishing the diagnosis the recommended treatment is the immediate surgical clearance of the primary aural abscess, together with if possible drainage of the intracranial abscess or evacuation of the lateral sinus disease under appropriate antibiotic cover. Whether the patient with intracranial disease is subsequently handled in the ORL or Neurosurgical wards depends upon ward facilities and interdepartmental liaison and cooperation.