Hostname: page-component-8678677fb7-bbpp6 Total loading time: 0 Render date: 2026-10-14T09:52:40.607Z Has data issue: false hasContentIssue false
  • English
  • Français

Otogenic brain complications: a systematic review and meta-analysis

Published online by Cambridge University Press:  05 March 2024

Eleni Gkrinia Open the ORCID record for Eleni Gkrinia [Opens in a new window] ,
Alexandros G Brotis ,
Kyriaki Vallianou ,
Anna Maria Ntziovara  and
Jiannis Hajiioannou Open the ORCID record for Jiannis Hajiioannou [Opens in a new window]
Eleni Gkrinia*
Affiliation:
ENT Department, University Hospital of Larissa, Larissa, Greece
Alexandros G Brotis
Affiliation:
Department of Neurosurgery, University Hospital of Larissa, Larissa, Greece
Kyriaki Vallianou
Affiliation:
ENT Department, University Hospital of Larissa, Larissa, Greece
Anna Maria Ntziovara
Affiliation:
ENT Department, University Hospital of Larissa, Larissa, Greece
Jiannis Hajiioannou
Affiliation:
ENT Department, University Hospital of Larissa, Larissa, Greece
*
Corresponding author: Eleni Gkrinia; Email: gkrinia.eleni@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

This study aimed to form astute deductions regarding the presentation, treatment and mortality of otogenic brain complications.

Methods

A systematic literature search of four medical databases (PubMed, Embase, Web of Science and Scopus) was conducted. Studies associated with otogenic brain complications were considered eligible. Fixed- and random-effects model meta-analysis was developed to assess the proportion estimate for each outcome individually.

Results

Twenty-eight studies, with 1650 patients in total, were included. In 66 per cent of patients there was a known history of chronic otitis media. The most common symptoms were purulent otorrhoea (84 per cent), headache (65 per cent) and otalgia (45 per cent). A brain abscess was observed in 49 per cent of patients, followed by meningitis (34 per cent) and sinus thrombosis (22 per cent). A combination of surgical and conservative therapy was chosen in 84.3 per cent of cases and the mortality rate approached 11.1 per cent.

Conclusion

Otogenic brain complications are a possibly life-threatening condition. Prompt imaging examination may set the final diagnosis and lead to an effective treatment.

Keywords

Otitis mediaotitis media with effusionmastoiditischolesteatomacommunicable diseases

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 138 , Issue 8 , August 2024 , pp. 828 - 837
Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Eleni Gkrinia takes responsibility for the integrity of the content of the paper

References

Minovi, A, Dazert, S. Diseases of the middle ear. GMS Curr Top Otorhinolaryngol Head Neck Surg 2014;13:Doc11Google ScholarPubMed
Van der Poel, NA, van Spronsen, E, de Loos DA, Dietz, Ebbens, FA. Early signs and symptoms of intracranial complications of otitis media in pediatric and adult patients: A different presentation? Int J Pediatr Otorhinolaryngol 2017;102:56–6010.1016/j.ijporl.2017.08.034CrossRefGoogle Scholar
Burton, BN, Saliba, J, Gabriel, RA, Harris, JP. Risk factors associated with mortality in patients with otogenic brain abscess. Otol Neurotol 2019;40:471–7CrossRefGoogle ScholarPubMed
Djeric, D, Arsovic, N, Djukic, V. Otogenic brain abscess: diagnostic and treatment experience. Int Congr Ser 2003;1240:61–5CrossRefGoogle Scholar
Özkaya, S, Bezircioǧlu, H, Sucu, HK, Özdemir, I. Combined approach for otogenic brain abscess. Neurol Med Chir (Tokyo) 2005;45:82–5CrossRefGoogle ScholarPubMed
Mukherjee, D, Das, C, Paul, D. Single-stage trans-mastoid drainage of otogenic brain abscess: a single-institution experience. Indian J Otolaryngol Head Neck Surg 2016;68:179–84CrossRefGoogle ScholarPubMed
Song, Y, Cheng, D, Qiu, K, Yan, X, Ren, J, Qiu, J et al. Clinical outcomes of different treatments and risk factors in patients with otogenic brain abscess, a real-world evidence-based retrospective study. Acta Otolaryngol 2020;140:919–2410.1080/00016489.2020.1800088CrossRefGoogle ScholarPubMed
Bradley, P, Manning, K, Shaw, M. Brain abscess secondary to otitis media. J Laryngol Otol 1984;98:1185–92CrossRefGoogle Scholar
Borgohain, R, Talukdar, R, Ranjan, K. Otogenic brain abscess: a rising trend of cerebellar abscess an institutional study. Indian J Otol 2015;21:286–9CrossRefGoogle Scholar
Sharma, N, Jaiswal, AA, Banerjee, PK, Garg, AK. Complications of chronic suppurative otitis media and their management: a single institution 12 years experience. Indian J Otolaryngol Head Neck Surg 2015;67:353–60CrossRefGoogle ScholarPubMed
Hafidh, MA, Keogh, I, Walsh, RMC, Walsh, M, Rawluk, D. Otogenic intracranial complications. A 7-year retrospective review. Am J Otolaryngol Head Neck Surg 2006;27:390–5Google ScholarPubMed
Page, MJ, McKenzie, JE, Bossuyt, PM, Boutron, I, Hoffmann, TC, Mulrow, CD et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Br Med J 2021;372:n71CrossRefGoogle Scholar
Sterne, JA, Hernán, MA, Reeves, BC, Savovic, J, Berkman, ND, Viswanathan, M et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. Br Med J 2016;355:4–10Google ScholarPubMed
NIH. Quality assessment tool for observational cohort and crosssectional studies 2018. In: https://www.nhlbi.nih.gov/healthtopics/study-quality-assessment-tools [1 May 2023]Google Scholar
Schünemann, H, Brożek, J, Guyatt, G, Oxman, A. GRADE Handbook for Grading Quality of Evidence and Strength of Recommendations. , 2013Google Scholar
R Core Team. R: a language and environment for statistical computing. In: https://cran.r-project.org/Google Scholar
Wolfowitz, B. Otogenic intracranial complications. Arch Otolaryngol 1972;96:220–2CrossRefGoogle ScholarPubMed
Wright, J, Grimaldi, P. Otogenic intracranial complications. J Laryngol Otol 1973;87:1085–9610.1017/S0022215100078014CrossRefGoogle ScholarPubMed
Lund, WS. A review of 50 cases of intracranial complications from otogenic infection between 1961 and 1977. Clin Otolaryngol Allied Sci 1978;3:495–501CrossRefGoogle ScholarPubMed
Samuel, J, Fernandes, C, Steinberg, J. Intracranial otogenic complications: a persisting problem. Laryngoscope 1986;96:272–8CrossRefGoogle Scholar
Kulali, A, Özatik, N, Topçu, I. Otogenic intracranial abscesses. Acta Neurochir (Wien) 1990;107:140–610.1007/BF01405793CrossRefGoogle Scholar
Singh, B, Maharaj, TJ. Radical mastoidectomy: its place in otitic intracranial complications. J Laryngol Otol 1993;107:1113–1810.1017/S0022215100125435CrossRefGoogle ScholarPubMed
Kurien, M, Job, A, Mathew, J, Chandy, M. Otogenic intracranial abscess. Concurrent craniotomy and mastoidectomy—changing trends in a developing country. Arch Otolaryngol Head Neck Surg 1998;124:1353–6CrossRefGoogle ScholarPubMed
Seven, H, Ozbal, AE, Turgut, S. Management of otogenic lateral sinus thrombosis. Am J Otolaryngol Head Neck Surg 2004;25:329-333Google Scholar
Leskinen, K, Jero, J. Acute complications of otitis media in adults. Clin Otolaryngol 2005;30:511–1610.1111/j.1749-4486.2005.01085.xCrossRefGoogle ScholarPubMed
Penido, NDO, Borin, A, Iha, LCN, Suguri, VM, Onishi, E, Fukunda, Y et al. Intracranial complications of otitis media: 15 years of experience in 33 patients. Otolaryngol Head Neck Surg 2005;132:37–4210.1016/j.otohns.2004.08.007CrossRefGoogle Scholar
Bento, R, De Brito, R, Ribas, GC. Surgical management of intracranial complications of otogenic infection. Ear Nose Throat J 2006;85:36–910.1177/014556130608500111CrossRefGoogle ScholarPubMed
Morwani, KP, Jayashankar, N. Single stage, transmastoid approach for otogenic intracranial abscess. J Laryngology Otol 2009;123:1216–2010.1017/S0022215109990533CrossRefGoogle Scholar
Alaani, A, Coulson, C, McDermott, AL, Irving, RM. Transtemporal approach to otogenic brain abscesses. Acta Otolaryngol 2010;130:1214–19CrossRefGoogle ScholarPubMed
Dubey, SP, Larawin, V, Molumi, CP. Intracranial spread of chronic middle ear suppuration. Am J Otolaryngol Head Neck Surg 2010;31:73–7Google ScholarPubMed
Wanna, GB, Dharamsi, LM, Moss, JR, Bennett, ML, Thompson, RC, Haynes, DS. Contemporary management of intracranial complications of otitis media. Otol Neurotol 2010;31:111–17CrossRefGoogle ScholarPubMed
Nawaz, G, Khan, AR, Rehman, A, Shahabi, I, Ahmed, I. Emergency management of otogenic intracranial abscesses in ENT setup. J Med Sci (Peshawar) 2013;21:217–21Google Scholar
Laulajainen-Hongisto, A, Aarnisalo, AA, Lempinen, L, Saat, R, Markkola, A, Leskinen, K et al. Otogenic intracranial abscesses, our experience over the last four decades. J Int Adv Otol 2017;13:40–6CrossRefGoogle ScholarPubMed
Yakobi, A, Porterfield, JZ, Toman, J, Spock, T, Kapil, N, De Meyer, J et al. HIV, tuberculosis, and otogenic intracranial sepsis: a devastating disease with a subtle presentation. Otol Neurotol 2019;40:E704–1210.1097/MAO.0000000000002290CrossRefGoogle Scholar
Duarte, MJ, Kozin, ED, Barshak, MB, Reinshagen, K, Knoll, RM, Abdullah, KG et al. Otogenic brain abscesses: a systematic review. Laryngoscope Investig Otolaryngol 2018;3:198–20810.1002/lio2.150CrossRefGoogle ScholarPubMed
Loh, R, Phua, M, Shaw, CKL. Management of paediatric acute mastoiditis: systematic review. J Laryngol Otol 2018;132:96–10410.1017/S0022215117001840CrossRefGoogle ScholarPubMed
Ziv, O, Sapir, A, Leibovitz, E, Kordeluk, S, Kaplan, D, El-Saied, S. Post-operative clinical course in children undergoing mastoidectomy due to complicated acute mastoiditis. Eur Arch Otorhinolaryngol 2022;279:3891–710.1007/s00405-021-07149-xCrossRefGoogle ScholarPubMed
Jain, A, Arora, N, Meher, R, Passey, JC, Bansal, R. Intracranial complications of CSOM in pediatric patients: a persisting problem in developing countries. Int J Pediatr Otorhinolaryngol 2017;100:128–31CrossRefGoogle ScholarPubMed
Ambrosio, A, Brigger, MT. Surgery for otitis media in a universal health care model: socioeconomic status and race/ethnicity effects. Otolaryngol Head Neck Surg (United States) 2014;151:137–41CrossRefGoogle Scholar
Nieman, CL, Tunkel, DE, Boss, EF. Do race/ethnicity or socioeconomic status affect why we place ear tubes in children? Int J Pediatr Otorhinolaryngol 2016;88:98–10310.1016/j.ijporl.2016.06.029CrossRefGoogle ScholarPubMed
Simon, AE, Boss, EF, Zelaya, CE, Hoffman, HJ. Racial and ethnic differences in receipt of pressure equalization tubes among US children, 2014. Acad Pediatr 2017;17:88–9410.1016/j.acap.2016.07.004CrossRefGoogle ScholarPubMed
Orji, FT, Ukaegbe, O, Alex-Okoro, J, Ofoegbu, VC, Okorafor, IJ. The changing epidemiological and complications profile of chronic suppurative otitis media in a developing country after two decades. Eur Arch Otorhinolaryngol 2016;273:2461–6CrossRefGoogle Scholar
Seydoux, C, Francioli, P. Bacterial brain abscesses: factors influencing mortality and sequelae. Clin Infect Dis 1992;15:394–40110.1093/clind/15.3.394CrossRefGoogle Scholar
Widdrington, J, Bond, H, Schwab, U, Price, A, Schmid, ML, McCarron, DR et al. Pyogenic brain abscess and subdural empyema: presentation, management, and factors predicting outcome. Infection 2018;46:785–9210.1007/s15010-018-1182-9CrossRefGoogle ScholarPubMed
Supplementary material: File

Gkrinia et al. supplementary material 1

Gkrinia et al. supplementary material
Download Gkrinia et al. supplementary material 1(File)
File 34.8 KB
Supplementary material: File

Gkrinia et al. supplementary material 2

Gkrinia et al. supplementary material
Download Gkrinia et al. supplementary material 2(File)
File 124.1 KB