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Indexed/Abstracted in: EMBASE, Scopus
Pia E., Policarpo M., Aluffi P., Borello G., Pisani P., Oliveri G. *, Bellotti C. *
Università del Piemonte Orientale «A. Avogadro» - Novara Clinica Otorinolaringoiatrica Azienda Ospedaliera Maggiore della Carità - Novara
*U.O. di Neurochirurgia
Intracranial complications of otological inflammatory pathologies have become less commonplace over the past few years due to the widespread use and progress of antibiotic treatments. The prognosis of these complications has also improved due to the use of imaging methods (CT and MR) which have affected the accuracy and promptness of diagnosis. The new therapies include the increasingly specific use of antibiotics and stereotaxic surgery. A total of 19 intracranial abscesses were treated between 1989 and 1999 at the Neurosurgery Unit and Department University of Novara. Two of these presented an otogenic pathogenesis and included a cerebral abscess localised in the left temporal lobe and a cerebral abscess. CT and MR imaging techniques were systematically used during diagnosis, together with scintigraphy with marked leukocytes in selected cases. Medical treatment was commenced at a full dose with targeted antibiotics, cortisone, osmotic diuretics and antiepileptics. Well-targeted antibiotic treatment calls for the preparation of specific culture media for (Gram- and Gram+ and anaerobic strains. The surgical cleansing of the septic foci (radical mastoidectomy or open TPL) and the aspiration of the abscess using a free technique and/or CT or MR guided stereotaxic method, which is more conservative than traditional techniques, have reduced both mortality and the incidence of morbidity.