A review of 50 cases of intracranial complications from otogenic infection between 1961 and 1977.

The records of 50 patients with intracranial complications of middle ear disease treated over the past 16 years have been reviewed. Virtually all the known intracranial consequences of middle ear infection have been encountered, and include cerebral abscess, cerebellar abscess, meningitis, lateral sinus thrombosis, otitic hydrocephalus and cortical thrombophlebitis. The clinical features, neurological signs and investigative data for each group have been compared and contrasted. Treatment in the past has consisted of radical and modified radical mastoidectomy. It is proposed that these techniques will continue to be preferred for the management of chronic otitis media in the presence of a condition as serious as an intracranial complication. It is concluded that with a quoted incidence of postoperative cholesteatoma as high as 40% intact canal wall techniques are not justified in these patients at present.