OTOGENIC INTRACRANIAL COMPLICATIONS : A REVIEW OF 3 CASES

• Published in: JIBI INKOKA TEMBO Vol. 56; no. Supplement1; pp. s34 - s39
• Main Authors: Yoshimura, Tomonori, Nakayama, Masahiro, Ashizawa, Kei, Tanaka, Shuho, Tabuchi, Keiji, Hirose, Yuki, Nishimura, Bungo, Okubo, Hideki, Wada, Tetsuro, Nakamagoe, Mariko, Hara, Akira, Hoshino, Tomofumi, Uemaetomari, Isao
• Format: Journal Article
• Language: Japanese
• Published: Society of Oto-rhino-laryngology Tokyo 05.03.2013; 耳鼻咽喉科展望会
• Subjects: epidural abscess; inner ear anomaly; mengitis; otogenic intracranial complication; sigmoid sinus thrombophlebitis; S状静脈洞血栓症; 内耳奇形; 硬膜外膿瘍; 耳性頭蓋内合併症; 髄膜炎
• ISSN: 0386-9687; 1883-6429
• DOI: 10.11453/orltokyo.56.s34

Although otogenic intracranial complications are considered to be relatively rare, they may still be potentially life-threatening. We report our experiences with 5 patients presenting with otogenic intracranial complications who were treated at the University of Tsukuba Hospital from 2002 to 2011. Case 1 was a 7-year-old girl who presented with fever, otalgia, and headache, who had been diagnosed as having acute otitis media at another hospital. Magnetic resonance imaging (MRI) demonstrated mastoiditis with sigmoid sinus thrombophlebitis. The child was successfully treated by intravenous antibiotic therapy. Case 2 was a male in his 60's who presented with the complaints of dizziness and vomiting. MRI showed an epidural abscess in the posterior cranial fossa caused by otitis media with a cholesteatoma. Abscess drainage, tympanoplasty and mastoidectomy were performed. Case 3 was a female patient in her 40's with inner ear anomalies associated with recurrent meningitis. During surgical treatment, cerebrospinal fluid leakage through a bony defect in the stapedial footplate was observed. After removal of the stapes, intralabyrinthine obliteration was performed and the oval window was sealed. The two remaining patients were two children with meningitis complicating otitis media with a cholesteatoma. Both cases were successfully treated by surgery. A clinical suspicion of otogenic intracranial complications would seem to be essential to make an accurate diagnosis during the early stage of the disease and achieve successful outcomes.