Epidemiology
Black patients had a markedly higher odds of inpatient mortality compared to White patients (OR: 45.81, 95% CI: 4.56-890.92, p=0.003) [PMID:30870360].
Management
In a retrospective cohort study of 252 patients, the mortality rate was similar between those who underwent mastoidectomy (3.6%) and those who did not (4.2%), with a p-value > 0.99 [PMID:30870360].
This paper reports that performing mastoidectomy followed by abscess excision through a trans-mastoid approach is technically feasible and effective, potentially clearing both the cause and effect of the pathology in one surgical session [PMID:16696514].
Based on initial experience, the authors advocate for further investigation into the trans-mastoid approach due to its effectiveness and logical approach to managing the infection source [PMID:16696514].
Prognosis & Follow-up
For every 10-year increase in age, the odds of inpatient mortality increased by 2.73 times (95% CI: 1.39-7.01, p=0.011) [PMID:30870360].
The authors conclude that while their experience is promising, more comprehensive prospective studies are required to fully evaluate the long-term prognosis and follow-up outcomes of this surgical technique [PMID:16696514].
References
1 Burton BN, Saliba J, Gabriel RA, Harris JP. Risk Factors Associated With Mortality in Patients With Otogenic Brain Abscess. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 2019. link 2 Razzaq AA, Jooma R, Ahmed S. Trans-mastoid approach to otogenic brain abscess. JPMA. The Journal of the Pakistan Medical Association 2006. link
2 papers cited of 3 indexed.