{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,10,26]],"date-time":"2024-10-26T04:18:45Z","timestamp":1729916325177,"version":"3.28.0"},"reference-count":23,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background:<\/jats:title>\n<jats:p>Otitis media (OM) can uncommonly lead to intracranial complications. Epidural abscesses represent a large proportion of cases; however, literature regarding the optimal surgical management of otogenic epidural abscesses is sparse. Favorably located epidural abscesses may be amenable to drainage through a transmastoid approach because the tegmen mastoideum lies immediately inferior to the middle cranial fossa (MCF).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description:<\/jats:title>\n<jats:p>We report 3 pediatric patients with OM complicated by epidural abscesses of the MCF. The ages ranged from 3 to 6 years old, with 2 females and 1 male. All 3 patients had acute mastoiditis with an abscess of the MCF ranging from 1.6 cm to 6.3 cm at the largest dimension. All patients underwent canal wall-up mastoidectomy with the evacuation of the MCF abscess through a small window, 0.7 \u00d7 0.7 cm or less, created in the tegmen mastoideum. All patients were successfully treated through this approach and had complete resolution of their infection on follow-up imaging. There were no postoperative temporal lobe encephaloceles.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion:<\/jats:title>\n<jats:p>This is one of the few descriptions of the treatment of an otogenic epidural abscess of the MCF through a transmastoid approach. Collaboration with neurosurgery is vital because their familiarity with the intracranial space helped to guide the accurate direction of dissection. This highlights the importance of a multidisciplinary approach in the treatment of epidural intracranial abscess of the MCF through this approach. The risk of postoperative temporal lobe encephalocele was minimized due to the small tegmen defect size.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_674_2024","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T09:25:40Z","timestamp":1729848340000},"page":"389","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Drainage of middle cranial fossa epidural abscess through mastoidectomy: Our experience and review of the literature"],"prefix":"10.25259","volume":"15","author":[{"given":"Max","family":"Feng","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Loma Linda University Health, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Vacaru","sequence":"additional","affiliation":[{"name":"Loma Linda University School of Medicine, Loma Linda, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikrum","family":"Thimmappa","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Loma Linda University Health, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Hanak","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Childrens Hospital of Orange County, Orange, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2024,10,25]]},"reference":[{"key":"10.25259\/SNI_674_2024\/ref-1","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1097\/00006454-199509000-00005","article-title":"Penicillin-resistant Streptococcus pneumoniae in acute otitis media: risk factors, susceptibility patterns and antimicrobial management","volume":"14","author":"Block","year":"1995","journal-title":"Pediatr Infect Dis J"},{"key":"10.25259\/SNI_674_2024\/ref-2","doi-asserted-by":"crossref","first-page":"110372","DOI":"10.1016\/j.ijporl.2020.110372","article-title":"Our experience on the management of acute mastoiditis in pediatric acute otitis media patients","volume":"138","author":"Duygu","year":"2020","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"10.25259\/SNI_674_2024\/ref-3","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/S0165-5876(00)00283-4","article-title":"Intracranial complications of acute mastoiditis","volume":"52","author":"Go","year":"2000","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"10.25259\/SNI_674_2024\/ref-4","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1016\/S0194-5998(98)70100-7","article-title":"Intratemporal complications of acute otitis media in infants and children","volume":"119","author":"Goldstein","year":"1998","journal-title":"Otolaryngol Head Neck Surg"},{"key":"10.25259\/SNI_674_2024\/ref-5","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/j.amjoto.2006.03.004","article-title":"Otogenic intracranial complications. 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