Læknablaðið - 15.03.1992, Page 21

LÆKNABLAÐIÐ
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Table I. CUnical course of central nervous system complications in 8 patients with otitis media and sinusitis.
Case Age Sex Source Presentation Complication Surgery Organism Outcome
1. 31 F R. chronic otitis media. Otorrhea Fever of unknown origin, stupor progressing to coma Subdural empyema R. occupital lobe abscess Craniotomy R. radical mastoidectomy Peptococci Eschirichia coli Full recovery
2. 54 M L. chronic otitis media. Otorrhea Confusion dysphasia L. temporal lobe abscess Craniotomy L. radical mastoidectomy Bacteroides melaninogenicus peptostreptococci Died
3. 57 F L. chronic otitis media Fleadache, otalgia Meningitis L. radical mastoidectomy Streptococcus pneumoniae Full recovery
4. 5 F L. purulent otitis media with etfusion Headache, diplopia papilloedema L. lateral sinus thrombosis Otitic hydrocephalus L. myringotomy L. simple mastoidectomy None cultured Full recovery
5. 9 F R. purulent otitis media R. otalgia R. facial nerve R. conductive paralysis hearing loss R. wide myringotomy and drainage Hemophilus influenzae Full return of nerve function in 3 days
6. 9 M L. ethmoid sinusitis L. maxillary sinusitis Rhinitis fever grand mal seizures Frontal lobe abscess subdural empyema Craniotomy L. ethmoidectomy and sinus irrigation Streptococcus milleri Full recovery
7. 36 M Frontal sinusitis Headache, rhinitis progressive apathy Epidural abscess Frontal lobe abscess Craniotomy x 2 Later cranioplasty Streptococcus milleri Full recovery
8. 62 F Frontal sinusitis Headache, progressive confusion Frontal lobe abscess Craniotomy followed by cranioplasty None cultured Full recovery
F: female M: male R: right L: left
Table II. Central nervous system complications of otitis
media and sinusitis (N=8).
Cerebral abscess......................... 5
Subdural empyema......................... 2
Epidural abscess......................... 1
Lateral sinus thrombosis................. 1
Otitic hydrocephalus..................... 1
Meningitis .............................. 1
heila, þar af tveir með undanfarandi bólgu í
ennisskútum. Þeir höfðu verið meðhöndlaðir
heima fyrir með sýklalyfjum og nefdropum
um nokkurra vikna skeið áður en ígerð kom í
ljós.
Sjúklingur 6, níu ára drengur, hafði bólgu í
kjálka- og sáldbeinsskútum (sinus maxillaris-
ethmoidalis). Versnandi einkenni á rúmri viku
leiddu til krampafioga. ígerð í heila greindist
við tölvusneiðmyndatöku.
Sjúklingur 7, 36 ára karl með ennisskútabólgu,
Fig. Frontal lobe cerebral abscess caused by frontal
sinusitis.