Vol.97 No.9 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 97 No.9 September 2004
A Case of Otogenic Intracranial
Complications
Secondary to Giant Cholesteatoma
Norimitsu Tanaka, Tatsuya Fukuiwa and Yuichi Kurono
(Kagoshima University)
Hirofumi Nishizono
(Nishizono Clinic)
Although the incidence of otogenic intracranial complications is decreasing, these complications are still serious problems in the otological field. We experienced a case of otogenic intracranial complications due to a giant cholesteatoma in a 77-year-old female. When she was transported to our hospital, she was unconscious. Examination by CT and MRI showed extradural abscess, brain edema and the destruction of the temporal bone. The anatomy of the ossicles and mastoid antrum was not detected. Abscess drainage by a retroauricular incision and the removal of the cholesteatoma were performed immediately. The day after surgery, the patient regained consciousness. The reason she had not complained of severe symptoms before she fell into a coma was not clearly explained. Since the cholesteatoma progressed slowly, central compensation might have been obtained. The present case suggests that immediate treatment is necessary for intracranial complications with advanced cholesteatoma, even if the symptoms are not specific and severe.
Key words : otogenic intracranial complications, cholesteatoma, brain abscess, compensation, Streptococcus milleri group