Abstract
Otitis media, especially chronic otitis media with cholesteatoma continues to be a frequent cause of intracranial complications despite the benefits of antibiotics and computed tomographic examinations. In the present study, we report two cases of intracranial complications caused by the uncommon infectious extension of cholesteatoma and granulations from the membranous labyrinth to the internal auditory meatus. The first case was a 44-year-old man with meningitis who was treated by intraveous antibiotics. Cholesteatoma and granulations were found to erode the surgical dome and extend to the fundus of the internal auditory meatus at surgery. The second case was a 40-year-old man who complained of right facial nerve palsy, fever and otalgia. A CT scan and MRI showed meningitis and cerebellar abscess secondary to labyrinthitis and cholesteatoma. In this case, cholesteatoma and granulations also extended to the fundus of the internal auditory meatus via the cochlea. Cholesteatoma has been infrequently reported to invade the fundus of the internal auditory meatus through the labyrinth. However, we should consider possible otogenic intracranial complications caused by labyrinthine extension of the cholesteatoma when we conservatively treat patients with cholesteatoma.
