Gower D, McGuirt W F
Laryngoscope. 1983 Aug;93(8):1028-33. doi: 10.1288/00005537-198308000-00010.
Among 334,884 admissions to the North Carolina Baptist Hospital from 1963 through 1982, 100 patients had central nervous system (CNS) complications of middle ear disease. The complications occurred predominantly in young patients, 85 of the 100 being less than 20 years of age. Meningitis occurred in 76 patients; the acute form was more prevalent (63 cases). The less common nonmeningitic complications included brain abscess (n = 6), effusion (n = 5), lateral sinus thrombosis (n = 5), otitic hydrocephalus (n = 5), and empyema (n = 3). Overall mortality was 10%. One patient with brain abscess died; 9 of the 76 patients with meningitis died (12%), with 4 of those deaths occurring among the 13 patients with chronic meningitis (31%). Because these complications have declined markedly since the advent of antibiotics, many contemporary otolaryngologists have been unexposed to these complications. However, as this series shows, they do still occur, their natural history remains the same, and the resulting mortality is still alarmingly high. A plea is made for otolaryngologists to maintain an awareness of these complications and to work with pediatricians and neurosurgeons for the best team care of patients with CNS complications of middle ear disease.
在1963年至1982年间入住北卡罗来纳浸礼会医院的334,884名患者中，有100例患有中耳疾病的中枢神经系统（CNS）并发症。这些并发症主要发生在年轻患者中，100例中有85例年龄小于20岁。76例患者发生了脑膜炎；急性形式更为常见（63例）。较不常见的非脑膜炎性并发症包括脑脓肿（n = 6）、积液（n = 5）、外侧窦血栓形成（n = 5）、耳源性脑积水（n = 5）和积脓（n = 3）。总体死亡率为10%。1例脑脓肿患者死亡；76例脑膜炎患者中有9例死亡（12%），其中4例死亡发生在13例慢性脑膜炎患者中（31%）。由于自抗生素问世以来这些并发症已显著减少，许多当代耳鼻喉科医生并未接触过这些并发症。然而，正如本系列所示，它们仍然会发生，其自然病史保持不变，由此导致的死亡率仍然高得惊人。呼吁耳鼻喉科医生对这些并发症保持警惕，并与儿科医生和神经外科医生合作，为患有中耳疾病中枢神经系统并发症的患者提供最佳的团队护理。
