Intracranial complications of chronic otitis media - case report

Written by Szőcs Mihály, Balázs Andor, Józsa Gita Erika

Introduction: Chronic otitis media may sometimes lead to potentially fatal intracranial complications, such as cerebral or cerebellar abscess, meningitis, epidural abscess, subdural empyema, otogenic hydrocephalus, lateral sinus thrombosis. We present a case of chronic otitis media, complicated with cerebellar abscess. Case report: We present the case of a 57 year old, male patient with a history of chronic otitis media. The disease had an insidious onset, with deteriorating symptomatology, such as the presence of characteristic neurological symptoms, like intracranial hypertension, vestibular syndrome, bulbar symptoms, precomatose state. In the first stage, neurosurgical drainage of the abscess by craniotomy was necessary, the etiology being chronic otitis media with cholesteatoma. The neurosurgical approach was followed by radical mastoidectomy as part of the second stage. The patient needed hospitalization in the intensive care unit and was given high-dose intravenous antibiotic therapy based on microbiologic testing. The postoperative evolution was favorable, the patient showing complete recovery. Conclusions: Cerebellar abcesses and other intracranial complications are rare in the presence of modern antibiotic therapy, and still, they pose a threat with potentially fatal outcomes. A close collaboration between ENT, neurosurgery, infectious disease, intensive care and radiology departments is crucial for the optimal treatment of these cases.


Keywords: chronic otitis media, intracranial complications, cerebellar abscess

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