真珠腫の感染により脳膿瘍を生じた先天性外耳道閉鎖例

抄録

Cholesteatoma is relatively rare with congenital aural atresia. Infected cholesteatomas sometimes cause intracranial complications, for example, meningitis, brain abscess, and lateral sinus thrombosis. We report a case of a 68-year-old female with congenital aural atresia who was diagnosed as having an otogenic brain abscess. She presented with otalgia, headache, nausea, and disturbance of consciousness. The findings on CT and MRI led to the diagnosis of brain abscess and infected cholesteatoma. The brain abscess was present around the brainstem. Complete removal of the cholesteatoma and brain abscess drainage were performed in addition to antibiotic administration. By day 80 after the surgery, brain abscess was found to have diminished in size and the patient had regained normal consciousness. Intracranial complications of infected cholesteatomas, including brain abscess, have a high mortality. Treatment of otogenic brain abscess involves complete removal of the cholesteatoma, abscess drainage, and antibiotic therapy. However, the optimal timing for the surgery is not yet established. For safe and effective treatment of otogenic brain abscess, cooperation between otolaryngologists and neurosurgeons/neurologists is desirable.