BRAIN-ABSCESS - WITH SPECIAL REFERENCE TO OTOLARYNGOLOGIC SOURCES OF INFECTION

The number of brain abscesses has been reduced since the preantibiotic era. This was accomplished by judicious use of antibiotics, by the ad vent of computed tomography, and by improvements in patient care and s urgical techniques. Analysis from 122 patients with brain abscess demo nstrated this trend of progress, Our series had a 3.2-to-1 male predom inance. The underlying conditions included otolaryngologic infections (26 cases), cyanotic heart diseases (27 cases), implantation abscess ( 25 cases), lung infections (5 cases), meningitis (4 cases), osteomyeli tis (2 cases), decreased immunity from chronic systemic diseases (12 c ases), and unknown causes (21 cases), Otolaryngologic subgroups can be detailed as chronic otitis media with cholesteatoma (15 cases), chron ic otitis media with mastoiditis (4 cases), sinusitis (2 cases), esoph ageal stenosis (3 cases), cheek cellulitis (1 case), and nasopharyngea l carcinoma (1 case). The initial symptoms and signs were headache (46 cases), fever (36 cases), altered consciousness (30 cases), neurologi c deficits (33 cases), vomiting (11 cases), and seizure (17 cases). Of the brain abscesses treated, multiple brain abscess represented 16.4% of all cases. The overall percentage of patients with full recovery w as 52.5%, whereas 84.8% of otolaryngologic subgroup recovered fully. T he overall mortality was 19.7%. The mortality rate of brain abscess fr om otolaryngologic sources was 3.8%, whereas that from nonotolaryngolo gic sources was 24%.