Otogenic brain complications: a systematic review and meta-analysis

J Laryngol Otol. 2024 Mar 5:1-10. doi: 10.1017/S0022215124000343. Online ahead of print.

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 media; cholesteatoma; communicable diseases; mastoiditis; otitis media with effusion.