Having lately observed three instances of fatal cerebral complications occurring in individuals suffering from suppurative disease of the middle ear, I accept this opportunity of narrating their histories, hoping they may prove of some interest.
When we recall the anatomic arrangement of this cavity, we are impressed with its immediate proximity to vital structures. The partition that separates the middle ear from the brain and its coverings, is but a thin portion of bone, with no diploe. Having little or no illumination, but being sufficiently supplied with heat and moisture, the middle chamber is an ideal incubator for the propagation of pathogenic microörganisms. Diseases of a suppurative character affecting this locality, have many factors to augment their vitality, but comparatively little resistance to limit their spread. It requires no stretch of imagination to picture a purulent inflammation extending through the roof of the tympanic cavity, and attacking cerebral structures.
LEDERMAN MD. CEREBRAL DISEASE FOLLOWING MIDDLE EAR SUPPURATION. JAMA. 1896;XXVII(11):574–578. doi:10.1001/jama.1896.02430890012002c
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