Cerebellar abscess secondary to middle ear cholesteatoma: A case report

We report a patient with cerebellar abscess secondary to middle ear cholesteatoma. A 39year-old man visited our clinic due to right otalgia of three days. Temporal bone CT revealed large bony destruction in the posterior fossa wall of the temporal bone. Ten days after the first visit to our clinic, he experienced severe vertigo with nausea. Suspecting intracranial complication, we performed brain CT, which revealed a cerebellar abscess with a midline shift of the cerebellum. Abscess drainage through the posterior fossa approach and the total removal of the cholesteatoma were performed simultaneously on an emergency basis. Now, two years after the surgery, the patient exhibits no neurological deficiency and has good hearing. Otogenic cerebellar abscess can be lethal, even in this era of antibiotics, because the typical symptoms are often masked by preceding antibiotic therapy. Immediate brain CT and surgical treatment are necessary for treating cerebellar abscess associated with advanced middle ear cholesteatoma.