title: Subdural empyema, retropharyngeal and parapharyngeal space abscess: unusual complications of chronic otitis media.
abstract: BACKGROUND
  Otitic complications arise from expansion of the middle ear infection. Subdural empyema is a rare otitic complication, and both retropharyngeal and parapharyngeal abscesses have been described in just a few cases.
  
  
  METHODS
  A 30-year-old male was, admitted as an emergency case because of breathing difficulties, secretion from the ear, and fever. Clinical examination had shown a purulent, fetid secretion from the ear, swelling on the roof of epipharynx, left tonsil pushed medialy, immobile epiglottis, reduced breathing space. Computed tomography revealed thick hypodense content filling cavity, mastoid entering the posterior cranial fossa, descending down throw the parapharyngeal space to the mesopharynx. On the roof and posterior wall of the epipharynx hypodense collection was also present. Tracheotomy was conducted, and incision of the parapharyngeal and retropharyngeal abscess and radical tympanomastoidectomy were performed. The patient's state deteriorated on the tenth postoperative day with hemiparesis and consciousness disorder. Magnetic resonance imaging was done. It showed subdural empyema of the left frontoparietal region and next to the falx, so craniotomy and abscess drainage were conducted.
  
  
  CONCLUSIONS
  Parapharyngeal, retropharyngeal abscess and subdural empyema are rare otitic complications. Adequate antibiotic therapy and radical surgical treatment make possible an outcome with survival.
authors: Clinic of Otorhinolaryngology, Clinical Center Kragujevac, Kragujevac, Serbia. ljiljana.erdevicki@gmail.com
authors: Ljiljana
authors: L
authors: Erdevicki
authors: Branislav
authors: B
authors: Belić
authors: Snezana
authors: S
authors: Arsenijević
authors: Ivan
authors: I
authors: Milojević
authors: Jasmina
authors: J
authors: Stojanović
mesh_terms: D000038:Abscess / Q000175:diagnosis / Q000209:etiology; D000328:Adult; D002908:Chronic Disease; D013354:Empyema, Subdural / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010033:Otitis Media / Q000150:complications*; D010608:Pharyngeal Diseases / Q000175:diagnosis / Q000209:etiology*; D017703:Retropharyngeal Abscess / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed