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January 1937


Arch Otolaryngol. 1937;25(1):48-56. doi:10.1001/archotol.1937.00650010056006

A review of the literature of the past twenty years discloses an enormous amount of material indicating the many possibilities of the clinical course in cases of septic meningitis of otitic origin when recovery takes place.1 An additional report of such a case is justifiable in view of the fact that recovery is rarely reported after surgical intervention confined to the temporal bone and its adnexa.2

PATHOGENESIS  Infection3 from the temporal bone to the meninges takes place: first, by way of the auditory nerve, terminating at the internal auditory meatus;4 second, by direct continuity of structures, either tegmentally to the cerebral fossa or by way of Trautmann's triangle to the posterior fossa;5 third, through persisting sutures and dehiscences;6 fourth, through the petrous pyramid, as described by Eagleton,7 Friesner,8 Kopetzky and Almour9 and others; fifth, through the aquaeductus cochlearis or the ductus endolymphaticus6 and sixth, through vascular routes-arterial,10 venous11 and lymphatic.12

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