title: Pediatric otogenic intracranial abscesses.
abstract: OBJECTIVE
  To describe the presentation and management of otogenic intracranial abscesses in a tertiary care pediatric hospital.
  
  
  METHODS
  Case series and chart review.
  
  
  METHODS
  Tertiary care pediatric hospital.
  
  
  METHODS
  An inpatient database was queried for the following diagnostic codes from 2000 to 2008: [383.2] petrositis, [383] acute mastoiditis, [386.3] labyrinthitis, [351.0] facial paralysis (Bell's palsy), [351.9] facial nerve disorder unspecified, [351.8] other facial nerve disorders, [383.01] subperiosteal abscess, [383.02] Gradenigo's syndrome, [320] meningitis, [324.9] extradural or subdural abscess, [324.0] intracranial abscess, [325] thrombosis of intracranial venous sinus, and [348.2] otic hydrocephalus. Presenting signs and symptoms, microbiology, length of stay, surgical findings, and outcomes were recorded for each patient.
  
  
  RESULTS
  Forty patients were identified with an otogenic intracranial complication. Thirty patients had evidence of an intraparenchymal, epidural, subdural, or petrous apex suppurative complication of otitis media. Twenty-four of 30 (80%) patients had a canal wall up mastoidectomy, three (10%) patients had a craniotomy without a mastoidectomy, and three (10%) patients were managed with intravenous antibiotics with or without pressure equalization tubes. There were no mortalities in this series of patients.
  
  
  CONCLUSIONS
  Patients with intracranial abscesses, in selected cases, can be managed with intravenous antibiotics without mastoidectomy. The use of canal wall up mastoidectomy is an acceptable alternative to radical mastoidectomy when surgical intervention is necessary.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75287, USA. Brandon.isaacson@utsouthwestern.edu
authors.forename: Brandon
authors.initials: B
authors.lastname: Isaacson
authors.forename: Christine
authors.initials: C
authors.lastname: Mirabal
authors.forename: J Walter
authors.initials: JW
authors.lastname: Kutz
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Lee
authors.forename: Peter S
authors.initials: PS
authors.lastname: Roland
mesh_terms: D000293:Adolescent; D001922:Brain Abscess / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D020227:Lateral Sinus Thrombosis / Q000209:etiology; D008416:Mastoid / Q000601:surgery; D010033:Otitis Media / Q000150:complications / Q000175:diagnosis; D012189:Retrospective Studies