Otitic cerebellar abscess / by Heinrich Neumann ; translated by Richard Lake.

Date:
1909
Catalogue details

Licence: In copyright

Credit: Otitic cerebellar abscess / by Heinrich Neumann ; translated by Richard Lake. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    this the antrum is considerably enlarged, and under certain circumstances it and the tympanic cavity may form a single large cavity. In spite of the enlargement of the cavity of the middle ear owing to absorption of the bony walls, the lumen is considerably reduced by the prolif- erating masses of granulations. Simultaneously with the absorption there is formation of new bone in other parts of the temporal bone, which leads to eburnization and the filling of numerous cells with dense osseous substance. There is thus proceeding at the same time in the middle ear a process of connective-tissue formation and one of disintegration, so that individual parts are sclerosed, whilst others experience necrotic disintegration. Owing to similar processes in the temporal bone, especially in acute recrudescence or as a result of a recent infection, the suppuration advances towards the cranial cavity. The carious and necrotic processes do not occur with the same frequency in individual parts of the temporal bone. The mastoid portion is most often affected; then follow in diminishing frequency the sigmoid fossa, the tegmen tympani et antri, the pars petrosa, including the internal ear, the posterior wall of the external meatus, the inferior wall of the cavum tympani, and finally the posterior wall of the carotid canal. The earlier view, that the encircling sclerosis in the neighbourhood of the carious and necrotic focus forms a natural protection against the transmission of the infection to the brain and meninges, can be accepted only to a limited extent, as the sclerosing ostitis is not always situated between the focus of disease and the middle or posterior fossa, but frequently in the external bone, whilst the necrosis proceeds in the dnection of the brain and meninges (Macewen). As clearly appears from my statistical investigation,