[Clinical analysis of otogenic intracranial complications].
OBJECTIVE
To analyze the clinical features and treatment protocols of otogenic intracranial complications in Peking Union Medical College Hospital.


METHODS
Retrospective study of 14 patients (10 males and 4 females, aged between 12 - 62 years, mean age 32.1 years) hospitalized from 1982 - 2006. Twelve cases were otitis media (OM) with cholesteatoma, the other 2 cases were non-cholesteatomatous OM. All the otogenic intracranial complications located at the same sides as otologic disorders. Brain abscess was the most common type of otogenic complications and Proteus was the most common microorganism detected. Suppurative ear discharge, headache, high fever and nausea with vomiting were the most common clinical manifestations with very high incidences. All the patients received combined protocols of mastoid surgeries and antibiotics treatment.


RESULTS
All the 14 patients recovered clinically. For patients discharged before 1987, there were 4 patients followed up for 22.5 - 24.4 years with a mean time of 23.8 without recurrence, 1 patient died of cardiovascular disease 19.2 years later after discharge, 4 patients lost follow-up. For the 5 patients discharged after 1997, brain abscess recurred in one patient with pseudo-recovery after 24 days and he fully recovered after re-hospitalization and treatment. All the five patients were followed up for 1.5 years to 10.6 years with a mean time of 6.5 years without recurrence.


CONCLUSIONS
Youngsters and males seemed to be more vulnerable. Brain abscess was the most common intracranial complication and Proteus was the most common pyogenic microorganism. Combination of mastoid surgery and antibiotics were essential for effectively controlling the intracranial complications and improving the recovery. CT and MRI were essential for correct diagnosis bedtimes and MRI seemed to have a better performance.
Yang
Hua
H
Department of Otorhinolaryngology, Peking Union Medical College Hospital, Beijing, China.
Chen
Xiao-wei
XW
Gao
Zhi-qiang
ZQ
Ni
Dao-feng
DF
Jiang
Hong
H
Xu
Chun-xiao
CX
Liu
Zheng-yin
ZY
Zhou
Bao-tong
BT
Yang
Da-hai
DH
D000293:Adolescent; D000328:Adult; D001922:Brain Abscess / Q000209:etiology*; D002648:Child; D004427:Ear Diseases / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000150:complications; D012189:Retrospective Studies; D055815:Young Adult