To know the most common type of the intracranial complications of otitis media.
If by this you mean brain infection(s) secondary to otitis media, then I do not think there are any at present in the UK, since I regard the OM as secondary to various cranial disorders, mainly CSF drainage problems. Hence when these conditions co-occur, the OM is unilateral. See my RG question on this (Does OM or mastoiditis cause fatal brain abscesses?).
Thank you dear Dr. Anthony G Gordon, I really appreciate your answer.
It''s been almost 40 years since I had any serious involvement in ENT, but in the UK, I always understood that the most common way that this happened was because OM gave rise to (chronic) mastoiditis, which in turn lead to the development of a cholesteatoma, which gradually erodes the bone in the attic, allowing pathogens into the skull, where they can then infect the meninges and brain substance. In my experience (currently not in ENT) this appears to be found as frequently as rocking horse manure.
However, in the world of ENT (rather than Occ Med clinics) things might be different, and I'm prepared to be contradicted, if necessary or appropriate.
Bw
Chris Ide
Intracranial complications are rare since the advent of antibiotics. In case of suspicion radiology cal, CT Scan, MRI, culture of pus will fix the diagnosis and help of neurosurgeon to perform surgery is essential.
"the most common way that this happened was because OM gave rise to (chronic) mastoiditis, which in turn lead to the development of a cholesteatoma, which gradually erodes the bone in the attic, allowing pathogens into the skull, where they can then infect the meninges and brain substance."
This is still the conventional view, bolstered by the success of modern medicine in treating infection(s). If this were entirely correct, there must be a dose relationship, ie the more severe, serious or chronic the OM, the more likely the intracranial spread. This is clearly not the case, in particular complications are characteristic of unilateral OM. Hippocrates has this sorted a long time ago, recognizing that a centrifugal fistula needed to precede a centripetal travel of organisms.
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