Abstract
Since the discovery of penicillin by Alexander Fleming in 1929 and the subsequent advent of other powerful antibiotics, otogenic intracranial complications which had been regarded with dread have been drastically decreased, even to the point that almost no attention is being given to its possible occurrence. However, when intracranial complications do occur, the prognosis is grave and such complications are associated with a relatively high mortality. Moreover, the rapid progress and reliance on antibiotic therapy and the abuse of the various antibiotic agents have wrought changes in the pathologic progress of the disease, masking the classical symptoms and signs in not a few instances and leading to misdiagnosis or a delay in arriving at the true diagnosis, not only by internists but also by otorhinologists.
On the other hand, less attention is being given to chronic infections of the middle ear because of the decreased incidence and trend toward milder cases but the incidence of cholesteatomas of the middle ear has not decreased. In relation to their site, growth, and resultant bone destruction, intracranial complications, once acute infections set in, are always a potential hazard and their presence should not be overlooked.
Four recent cases of otogenic intracranial complications, 2 with thrombosinusitis and 2 postoperative intracranial complications (3 associated with cholesteatomas) are reported and a statistical review of intracranial complications of otogenic origin in Japan for the past 15 years from 1961, particularly in relation to the presense of cholesteatomas of the middle ear, is given.
