[FEATURES OF OTOGENIC INTRACRANIAL COMPLICATIONS AT THE PRESENT STAGE].

A retrospective analysis of treatment was made in 127 adult patients with acute and chronic otitis media complicated by suppurative-inflammatory pathology of the brain. Purulent meningitis was revealed in 52 (40.9%) of hospitalized patients. Meningoencephalitis was often diagnosed in the cases of acute otitis media (15.4%) and in cases of chronic otitis (22.7%). The otogenic brain abscess was detected in 13.5% of otitis media cases and it was noted to be twice frequent (33.3%) in cases of purulent otitis media. The patients 124 (97.6%) have been operated. An extended mastoidotomy and antromastoidotomy were performed in the acute purulent otitis media. An extended radical operation on the ear was applied in case of chronic otitis media. Performance of craniotomy and complete removal of the abscess using modern systems of neuronavigation showed a higher clinical efficacy as compared with transtemporal approach during sanitizing intervention on the ear including the opening and abscess drainage in surgery of otogenic abscesses of the brain.

[Assessment of etiological diagnostics in adults with aseptic encephalomeningitis--own material]. / Ocena diagnozowania etiologii limfocytowych zapalen opon mózgowych i mózgu u doroslych w materiale wlasnym.

OBJECTIVE: Epidemiologic, etiologic and clinical assessment of patients with aseptic encephalomeningitis (AE); evaluation of efficacy of diagnostic process. METHODS: From January 1996 to August 2002, in seventy seven patients AE was diagnosed on the basis of lymphocytic predominance in cerebrospinal fluid (CSF) and negative culture of CSF. Analysis comprised: etiology, course of the disease and spectrum of used diagnostic tests. RESULTS: In 48/77 patients (62.3%) etiology was not identified. In 8/77 patients (10.3%) herpes simplex encephalitis was diagnosed, in 7/77 (9.1%) neuroborreliosis, in 6/77 (7.8%) tuberculosis encephalitis, in 3/77 (3.9%) listerial meningitis, in 3/77 (3.9%) mumps meningitis, and in remaining 2/77 (2.6%) tick-borne encephalitis. The incidence of AE was higher in summer (42.9%) than in any other season. In 14/77 patients (18.2%) the episode of unconsciousness occurred in the course of the disease. In 6 of these 14 patient etiology was unknown, in 4 tuberculosis AE, in 2 herpes simplex encephalitis and in 2 neuroborreliosis was diagnosed. In 7 of 77 patients (9.0%) et least one episode of convulsions occurred. CONCLUSIONS: In 62.3% of patients etiology remained unknown due to clinical and economic reasons. Aseptic encephalomeningitis in adults not always mean the viral etiology and mild course of the disease.