[Endocranial complications of cholesteatoma: apropos of 8 cases]

Abstract

The authors present a recent series of 8 cases of intracranial complications secondary to cholesteatoma. The series is made up of 3 temporal lobe abscesses, 1 parietal lobe abscess, 1 cerebellar abscess, 1 extradural abscess, one lateral sinus thrombo-phlebitis with subdural abscess and one meningitis on its own. Otological management with removal of the cholesteatoma was by open or closed technique, depending on the local anatomical conditions. It was supplemented by multiple antibiotic therapy, in turn guided by the bacteriological cultures and by any known epidemiological information. It was necessary to needle the abscess by a neurosurgical approach in two cases. The results of bacteriological samples taken for analysis from the intracranial abscesses are often negative, which limits their clinical value. In such cases, the choice of antibiotics rests on epidemiological information. The authors emphasise the progress that has been made towards the early diagnosis of intracranial complications. Appropriate combined medical and surgical treatment leads to complete cure without neurological sequelae in most cases.