Management of otitic hydrocephalus; with particular attention to the effect of antibiotics.

Otitic hydrocephalus as a complication of otitis media is probably not so rare as is generally assumed. The onset is insidious and first symptoms are vague. Even after signs of elevated cerebrospinal fluid pressure appear, differential diagnosis remains a difficult problem. On the basis of what is known of the pathologic features and clinical course of otitic hydrocephalus a plan for the prevention and management of this complication is suggested. In children and adolescents with a history of recurrent otitis media and other conditions likely to produce hydrocephalic disturbances, new episodes of otitis media must be treated along classical lines, notwithstanding supplementary use of antibiotics. After recovery, extended follow-up observation is required, which should include repeated ophthalmoscopic examinations. A finding of changes in the eyegrounds calls for neurologic evaluation. Energetic treatment, particularly daily spinal taps, may prevent ultimate blindness.