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After the development of streptococcic meningitis one is usually powerless to stop or allay it. Kolmer, Eagleton, Kopetsky and others are advocating its anticipation with premeningitis therapy. The alert otologist should have a thorough knowledge of pathologic processes and a broad experience in otology to evaluate premeningitic signs and symptoms and to prevent the development of meningitis before or after mastoidectomy.
It is impossible without too lengthy discussion to review the anatomy and physiology of the meninges, but a few of the pathologic processes that excite meningitis must be mentioned in order to understand premeningitic symptoms. Otitic meningitis usually develops from an extradural or an intrameningeal abscess in the middle or posterior fossa, thrombotic infection, embolic infection, rupture of an abscess of the brain, fracture of the skull through the tegmen or mastoid process or purulent labyrinthitis.
It is well to bear in mind that the meninges, especially
CASSADY JV. OTITIC MENINGITIS. Arch Otolaryngol. 1932;16(2):176–181. doi:10.1001/archotol.1932.00630040185003
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