This important subject in the field of otology calls for a classification of cerebral affections that are the result of chronic middle-ear suppuration. Such complications divide themselves into:
Inflammation of the meninges, which include (a) extradural abscess, (b) intradural abscess, (c) purulent and serous meningitis.
Diseases of the brain, which include (a) abscess, (b) diffuse inflammation.
Diseases of the sinuses of the dura mater.
Diseases of the internal carotid artery.
I wish it to be understood that I believe in the operative treatment of purulent meningitis due to chronic suppuration of the middle ear for the following reasons: First, because the constantly increasing numbers of these affections that have been cured by drainage make this seem the only way in which we may hope to achieve more success than we have up to the present, and, second, the differential diagnosis of meningitis and brain abscess is at times so involved
WELTY CF. INDICATIONS FOR OPERATIVE INTERFERENCE IN CEREBRAL COMPLICATIONS DUE TO CHRONIC SUPPURATION OF THE MIDDLE EAR.. JAMA. 1908;L(6):447–450. doi:10.1001/jama.1908.25310320035001h