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Science articles
Science articlesDemographic, clinical and epimiological features of otogenic intracranial complications at the present stage
A. A. Krivopalov (1), Y. K. Yanov (1), S. V. Astaschenko (1), A. Y. Shcherbuk (2), S. A. Artyushkin (3), S. G. Vahrushev (4), I. S. Piskunov (5), V. S. Piskunov (5), N. A. Tuzikov (5)
(1) Saint Petersburg Research Institute of Ear, Throat, Nose and Speech, Saint Petersburg, 190013, Russia (2) Saint Petersburg State University, Saint Petersburg, Russia (3) North-Western State Medical University named after I. I. Mechnikov, Saint Petersburg, Russia (4) Krasnoyarsk State Medical University named after Prof. V. F. Voino-Yasenetsky, Krasnoyarsk, Russia (5) Kursk State Medical University, Kursk, Russia (6) Municipal Polyclinic N 32, Saint Petersburg, Russia
UDK: 616.831-002.3-02:616.28-036.2:614.1
DOI: https://doi.org/10.18692/1810-4800-2016-1-48-61
ABSTRACT
The importance of the intracranial complications problem in acute and chronic focal processes of ENT organs is determined by their dominating position among the reasons of the fatal outcomes. The authors made retrospective analysis of all the clinical cases of inpatient treatment of 127 adult patients with acute and chronic otitis media, complicated with pyoinflammatory cerebral pathology. Chronical suppurative otitis media predominated in the general structure of the revealed otitis media pathology structure – 75 (59.0%) cases. Purulent meningitis was diagnosed in 52 (40.9%) received patients, in acute otitis it constituted 63.5% of the total intracranial complications, and in chronic otitis media – only 25.3%. Meningocephalitises have been diagnosed with equal frequency both in acute otitis media – 15.4%, and in chronic otitis media – 22.7%. Otogenic brain abscesses have been diagnosed only in 13.5% cases of acute suppurative otitis media, whilst in chronic suppurative otitis media they have been revealed twice more frequent – 33.3%. 124 (98%) patients underwent surgery due to otogenic intracranial complications. For the purpose of sanation of the primary focus of infection in the ear the following therapy was conducted: in acute supportive otitis media – extended mastoidotomy, antromastoidotomy; in chronic suppurative otitis media – extended radical ear surgery. In surgical therapy of otogenic brain abscess, craniotomy and complete removing of the brain abscess using advanced neuronavigation systems proved higher clinical efficacy compared to transtemporal access in the course of sanation intervention in the ear with the abscess incision and drainage. Nowadays, the main clinical features of otogeneous intracranial complications are: severe central nervous system inflammatory damage with prevalence of cerebral and meningeal symptoms, high severity of the general state of the patients with the development of purulent septic complications with mortality level.
Publication date:
03.02.2016
Keywords:
specialized otorhinoloringological care, neurosurgical specialized care, otogenic intracranial complications For citation:
Krivopalov A. A., Yanov Y. K., Astaschenko S. V., Shcherbuk A. Y., Artyushkin S. A., Vahrushev S. G., Piskunov I. S., Piskunov V. S., Tuzikov N. A. Demographic, clinical and epimiological features of otogenic intracranial complications at the present stage. Rossiiskaya otorinolaringologiya. 2016;1:48-61. https://doi.org/10.18692/1810-4800-2016-1-48-61