[Problems of diagnosis and treatment of otogenic abscesses of the brain in children]

Abstract

In 1947-89, 49 children with otogenic abscesses of the brain and cerebellum were treated in the ENT department of the Kuban Medical Institute. During the first two decades the number of these patients was 34 and during the second two decades it was 15, i.e., the number decreased two-fold. In 25 cases, abscesses were located in the temporal lobe, in 14 cases--in the cerebellum, and in 10 cases, multiple abscesses of different localization were diagnosed. For diagnostic purposes electroencephalography, echoencephalography, angiography, pneumography and ventriculography were used although they were sometimes inefficient, especially in the cases of multiple abscesses. Computer tomography made it possible to determine not only the number but also specific localization of abscesses. The method was applied in 8 cases. After proper examination and treatment all the patients recovered. Out of 49 patients 28 recovered and 21 died. Out of 34 patients treated during 1947-67, 17 recovered and 17 died while out of 15 patients treated during 1968-1989, 11 recovered and 4 died. It can be concluded that a significant reduction of the number of cases with brain abscesses and a substantial increase of the success rate can be attributerd to the advanced methods of their detection (echoencephalography and computer tomography) and more efficient methods of therapy of middle ear suppuration.