Case Report
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World J Clin Cases. Oct 6, 2022; 10(28): 10220-10226
Published online Oct 6, 2022. doi: 10.12998/wjcc.v10.i28.10220
Potential otogenic complications caused by cholesteatoma of the contralateral ear in patients with otogenic abscess secondary to middle ear cholesteatoma of one ear: A case report
Li Zhang, Xun Niu, Kun Zhang, Ting He, Yu Sun
Li Zhang, Xun Niu, Kun Zhang, Ting He, Yu Sun, Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Author contributions: Zhang L, Niu X, Zhang K, He T, and Sun Y designed the study; Zhang L and Sun Y analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no potential conflicts of interest concerning the research, authorship, and/or publication of this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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Corresponding author: Yu Sun, MD, PhD, Vice Chairman, Chief Physician, Professor, Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Hongshan District, Wuhan 430022, China. sunyu@hust.edu.cn
Received: April 23, 2022
Peer-review started: April 23, 2022
First decision: June 8, 2022
Revised: June 21, 2022
Accepted: August 15, 2022
Article in press: August 15, 2022
Published online: October 6, 2022
Processing time: 156 Days and 20.2 Hours
Abstract
BACKGROUND

Otogenic brain abscess caused by middle ear cholesteatoma is a potentially serious and life-threatening complication in the ear, nose, and throat clinic. The mortality rate associated with otogenic brain abscesses is 8%–26.3%. Recently, in China, the incidence of brain abscess secondary to middle ear cholesteatoma has started to increase due to antibiotic resistance.

CASE SUMMARY

A 55-year-old male presented hearing loss in the right ear and headache for 1 mo in 2018. Computed tomography (CT) showed an area of low density in the right middle ear and mastoid and auditory ossicle defects and a small amount of soft tissue density in the left middle ear. The parietal wall of the right tympanic cavity and the posterior wall of the mastoid sinus were thin and less continuous. Cranial magnetic resonance imaging revealed an area of low intensity encapsulated by an area of high intensity in the right temporal lobe. We diagnosed him with a brain abscess secondary to middle ear cholesteatoma. He received surgery to drain the abscess followed by a modified radical mastoidectomy. The patient visited our department 3 years later because of intermittent otorrhea in the left ear. CT revealed that the area of the soft tissue density in the left middle ear and mastoid was significantly increased. The posterior wall of the mastoid sinus was destroyed, leaving the left middle ear connecting with the brain. The patient underwent a modified radical mastoidectomy in the left ear

CONCLUSION

Regular follow-up and timely treatment of contralateral ear disease are vital for the prevention of otogenic complications in patients with otogenic abscesses secondary to middle ear cholesteatoma in the unilateral ear.

Keywords: Middle ear cholesteatoma; Otogenic complications; Brain abscess; Case report

Core Tip: There are few studies about the occurrence of a cholesteatoma in the contralateral ear in patients with otogenic brain abscess secondary to cholesteatoma in the unilateral ear. Here, we report a case of cholesteatoma in the contralateral ear with the destruction of the posterior wall of the mastoid sinus three years after curing middle ear cholesteatoma complicated with an otogenic intracranial abscess in the unilateral ear, reminding us of the importance of the detailed examination in regular follow-up and timely treatment.