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Query: UMLS:C0262471 (ENT)
 5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In spite of refined diagnostic and therapeutic possibilities, the cerebral abscess continues to be a disease involving great risks. A comparison of surgically treated groups of patients of the periods 1954 to 1962 and 1963 to 1977 does not show any reduction in lethality. This amounted to 15 per cent for the first group and 17.6 per cent for the second group. Extirpation of cerebral abscesses shows the most favourable results of treatment as compared to other surgical procedures. In our opinion, however, it will not remain the only method of treatment in future because it can only be employed if the patient is in a condition permitting an operation. That is why the open abscess treatment will continue to be justified for all cases where cerebral abscesses occur in combination with subdural or epidural empyemas. Certainly, modern anaesthesia methods as well as intensive pre- and postoperative therapy will further reduce the number of patients who are subjected to a primary puncture treatment. Since 1972, we have treated our patients exclusively by abscess exstirpations. Until 1977, none of the total number of 12 patients treated by us has died. We consider the use of scintigraphic and EEG controls of inflammatory cerebral processes to be of decisive importance. These controls enable a differentiation between diffuse and local inflammatory processes which are accompanied by a liquefaction and in this way permit the selection of the optimum time of operation. A basic condition, however, will always be a good interdisciplinary co-operation with infection departments, paediatric and ENT hospitals where in most cases patients suffering from brain abscesses are first admitted.
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PMID:[The brain abscess today]. 74 31

Seventy-four verified cases of cerebral abscess seen in the Regional Neurosurgical Centre at Addenbrookes Hospital, Cambridge between 1965 and 1987 were reviewed. During that time no decline in incidence or change in the associated mortality was found to occur. ENT disease, taken as a whole, represented the most common source (40%) while acute frontal sinusitis (23%) proved to be the most common single underlying cause. Cerebral abscesses of sinogenic origin in particular were diagnosed late, with a deteriorating conscious level being the precipitating event in 94% of cases. Over 80% of such patients had presented initially to a non-ENT department with acute frontal headache where neither the underlying frontal sinusitis nor the developing intracranial complication had been suspected. These findings might explain why the incidence and mortality associated with cerebral abscesses of sinogenic origin, have changed little in the last 25 years despite improvements in diagnostic imaging, surgical technique and antibiotic therapy. We recommend that the diagnosis of acute frontal sinusitis be considered in any patient who presents with acute frontal headache, particularly if symptoms are unilateral. Furthermore, we stress that early confirmation of intracerebral complications by computerized axial tomography (CT) scanning continues to depend entirely upon an early clinical diagnosis which should result from a high level of clinical suspicion in patients who develop intracranial symptoms in the presence of known acute frontal sinus infection.
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PMID:Persisting incidence and mortality of sinogenic cerebral abscess: a continuing reflection of late clinical diagnosis. 202 39

The CT scanner and the recognition of anaerobic organisms has altered the investigation and management of intracranial suppuration. Improved treatment of acute and chronic middle ear infection has also occurred. A 15 year retrospective review was undertaken to assess the effects of these changes. The ears and sinuses were confirmed as the major source of intracranial suppuration (69%) although initial presentation to ENT surgeons was less common (14%). Ear complications occur in childhood and in the fifth and sixth decades; sinus complications predominantly in the second and third decades. The incidence of sinus infection appears to be rising. With the introduction on the CT scanner cerebral abscess mortality declined from 27.5% to 6.5% and subdural abscess mortality halved. The introduction of metronidazole contributed to a drop in mortality. The use of the CT scanner and more accurate antibacterial treatment, including metronidazole, gives hope for a more successful outcome than was previously possible.
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PMID:Intracranial suppuration 1968-1982--a 15 year review. 615 10

A young man with otitis media and cholesteatoma of the left ear developed secondary cerebral abscess. The clinical debut was non-specific, with headache, mild fever, and mild persistent otalgia in spite of early antibiotic treatment. Studies revealed a cerebral abscess, so ENT surgery in collaboration with the neurosurgery department was decided. This case illustrates that clinical manifestations in such cases can be mild and highlights the need to exclude this type of serious pathology.
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PMID:[Otogenic cerebral abscess: a persistent problem]. 1080 19