Proper management of chronic otitis media may reduce the incidence of otogenic brain abscess. The aim of this study was to describe the clinical profile, treatment and surgical outcome of patients presenting with otogenic brain abscess. The medical record of patients in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) with otogenic brain abscess were retrospectively analyzed from January 1997-January 2006. Within this period we had approximately 10,800 of follow up cases of chronic otitis media (COM) in our clinic. Ten patients (2 females, 8 males) with an average age of 42 (age range 11 to 69 years) were identified with otogenic brain abscess and included in this study. The mean follow-up period was 14 months. All patients had cholesteatoma. All patients had a history of chronic ear discharge, headache, otalgia and fever. Six of the 10 patients had cerebellar abscess and 4 had temporal lobe abscess. Cerebellar signs were present in 3 patients. All the patients were treated with broad-spectrum antibiotics. In 5 patients, mastoid exploration was the primary surgical treatment and the brain abscesses were treated conservatively. In the other 5 patients, craniotomy and drainage were performed followed by mastoid exploration when their neurological conditions had stabilized. All our patients had uneventful recovery. There were no permanent cerebellar signs during the follow up and no mortality reported in our series. In this series we demonstrated that early diagnosis and proper treatment of otogenic abscess leads to good neurological outcome.
Otogenic Brain Abscess: A Retrospective Study of 10 Patients and Review of The Literature
Author
Abstrak
Rawatan otitis media kronik yang betul boleh mengurangkan insiden abses otogenik otak. Objektif kajian ini adalah untuk menilai profil klinikal, rawatan dan kesan pesakit yang didiagnos dengan abses otogenik otak. Rekod perubatan pesakit di Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) yang dirawat sebagai abses otogenik otak dari Januari 1997 sehingga Januari 2006 dianalisa secara retrospektif. Dalam tempoh tersebut seramai lebih kurang 10,800 pesakit mengalami jangkitan telinga tengah kronik mendapat rawatan susulan di Klinik Telinga Hidung dan Tekak, PPUKM. Sepuluh pesakit (2 perempuan, 8 lelaki) dengan purata umur 47 tahun (umur di antara 11 sehingga 69 tahun). Min bagi jangka masa rawatan susulan adalah 14 bulan. Semua pesakit menghidapi kolesteatoma. Kesemua pesakit mempunyai sejarah discaj telinga yang kronik, sakit kepala, sakit telinga dan demam. Enam dari 10 pesakit mempunyai abses serebelar dan 4 mempunyai abses lobar temporal. Kesemua pesakit dirawat dengan antibiotik spektrum luas. Lima pesakit menjalani pembedahan mastoidektomi sebagai rawatan utama manakala abses otak dirawat secara konservatif. Manakala lima pesakit lagi menjalani pembedahan kraniotomi dan pengaliran nanah diikuti dengan pembedahan mastoid apabila fungsi neurologi sudah stabil. Tiada pesakit yang mempunyai tanda serebelar yang kekal ketika rawatan susulan dan tiada kes kematian. Di sini kami menunjukkan bahawa rawatan awal dan tepat bagi pesakit abses otogenik otak memberikan hasil pemulihan neurologi yang baik.
Kata kunci
Abstract
|
|
|
Related Images
