Клинико-патогенетические особенности и исходы отогенных внутричерепных осложнений при остром и хроническом гнойном среднем отите

Abstract

Introduction. To date, there are conflicting data on the frequency, structure, and severity of the clinical course of otogenic intracranial complications in various ear diseases. Objective. Investigation of the features of pathogenesis, clinic, and outcomes of otogenic intracranial complications in acute purulent otitis media and exacerbation of chronic purulent otitis media. Patients and methods. The gender, age, ways of infection of the cranial cavity, the timing of the prodromal period and the prehospital stage of observation, the level of consciousness at admission, the structure and outcomes of intracranial complications in 32 (62,7%) patients with acute purulent otitis media and in 19 (37,3%) patients with exacerbation of chronic purulent otitis media were studied. Conclusions/Results. In the groups of patients with acute purulent otitis media and exacerbation of chronic purulent otitis media, the hematogenic pathway of infection of the meninges was found, respectively, in 87,5% and 47,4%; fulminant and acute course of otogenic purulent meningitis, in 75% and 47,4%; the development of coma and sopor at the prehospital stage, in 81.3% and 47.4%; and fatal outcomes, in 31,3% and 26,3% of cases. The development of coma at the prehospital stage and hospitalization later than 24 hours after the onset of the manifestation of symptoms of otogenic purulent meningoencephalitis significantly increased the number of deaths, to a greater extent in acute purulent otitis media than in exacerbation of chronic purulent otitis media.