Læknablaðið - 15.03.1992, Blaðsíða 23
LÆKNABLAÐIÐ
97
kann að vera nauðsynleg ef um langvarandi
bólgu er að ræða.
Einungis einn sjúklingur greindist með
heilahimnubólgu af völdum langvinnrar
eymabólgu. Bólga í stikli og miðeyra hafði
valdið beineyðingu og opnað greiða leið að
heilahimnu.
Langvinnir eymasjúkdómar, svo og beináta
(cholesteatoma) valda á tíðum þynningu á
beini milli miðeyra og stikils annars vegar og
heilahimnu hins vegar. Sýkingar eiga þannig
hægara um vik að breiðast frá miðeyranu til
miðtaugakerfis (8,14,15).
Að framan hafa verið ræddir ýmsir alvarlegir
fylgikvillar við miðeyma- og skútabólgu,
sjúkdóma sem eru mjög algengir á íslandi
og víðar á Vesturlöndum. Sýklalyfjagjöf kann
að gefa falska öryggiskennd, en alvarlegir
fylgikvillar geta engu að síður verið á næsta
leiti, með hastarlegum afleiðingum. Þessir
fylgikvillar eru sjaldséðir en full ástæða er
til að minna aftur á tilveru þeirra.
SUMMARY
Otitis media and sinusitis are common diseases.
Between 1981 and 1990 eight patients were treated
at Borgarspítalinn for serious central nervous
system complications from infections of the middle
ear and sinuses. Twelve complications were found
in these 8 patients. Cerebral abscess was the most
common and serious complication and caused death
in one patient. With the advent of broad-spectrum
antibiotics the clinical course of middle ear disease
and sinusitis has been altered. The clinician may
be falsely assured that administration of antibiotics
will result in complete resolution of these diseases
while unsuspected complications can go undetected.
ÞAKKIR
Kristín Snorradóttir læknafulltrúi á háls-,
nef- og eymadeild Borgarspítalans sá um
ritvinnslu. Eru henni færðar bestu þakkir.
HEIMILDIR
1. Tumer AL, Reynolds EE. Intracranial pyogenic
disease. Edinburgh: Oliver and Boyd, 1931.
2. Jeanes A. Otogenic intracranial suppuration. J
Laryngol Otol 1962; 76: 388-402.
3. Schwaber MK, Pensak ML, Batels LJ. The early
signs and symptoms of neurologic complications of
chronic suppurative otitis media. Laryngoscope 1989;
99: 373-5.
4. Brand B, Caparosa RJ, Lubic LG. Otorhinological
brain abscess therapy-past and present. Laryngoscope
1984; 94: 483-7.
5. Samuel J, Femandes CMC, Steinberg JL. Intracranial
otogenic complications: a persisting problem.
Laryngoscope 1986; 96: 272-8.
6. Maniglia AJ, Van Buren JM, Bruce WB, Bellucci RJ,
Hoffmann SR. Intracranial abscess secondary to ear
and paranasal infection. Otolaryngology, Head and
Neck Surgery 1980; 88: 670-80.
7. Meyerhoff WL, Kim CS. Pathology of Chronic Otitis
Media. Ann Otol Rhinol Laryngol 1978; 87: 749-60.
8. Holt GR, Gates GA. Masked Mastoiditis.
Laryngoscope 1983; 93: 1034-7.
9. Gower D, McGuirt WF. Intracranial complications of
acute and chronic infectious ear disease: a problem
still with us. Laryngoscope 1983; 93: 1028-33.
10. Browning GG. The unsafeness of »safe« ears. J
Laryngol Otol 1984; 98: 23-6.
11. Hoyt DJ, Fisher SR. Otolaryngologic management of
patients with subdural empyema. Laryngoscope 1991;
101: 20-4.
12. Teichgraeber JF, Per-Lee JH, Tumer JS. Lateral sinus
thrombosis: a modem prespective. Laryngoscope
1982; 92: 744-51.
13. Foley J. Benign forms of intracranial hypertension.
»Toxic« and »Otitic« hydrocephalus. Brain 1955; 78:
1-41.
14. Bradley PJ. Manning KP, Shaw MDM. Brain abscess
secondary to otitis media. J Laryngol Otol 1984; 98:
1185-91.
15. Samuel J, Femandes CMC. Otogenic Complications
with an intact tympanic membrane. Laryngoscope
1985; 95: 1387-90.
16. Quick CA, Payne E. Complicated acute sinusitis.
Laryngoscope 1972; 82: 1248-63.