小脳膿瘍を伴った真珠腫性中耳炎例

抄録

We report a case of cerebellar abscess and sigmoid sinus thrombophlebitis secondary to middle ear cholesteatoma. A 77-year-old female was referred to our clinic with right otorrhea, earache, headache, fever and gate disturbance. CT revealed bony destruction in the posterior fossa of the temporal bone and a cerebellar abscess in the right cerebellum. Emergency abscess drainage via a posterior fossa approach was performed by neurosurgeons, followed by total removal of the cholesteatoma 47 days later. Eight months after the surgery, she recovered her previous mental and physical level and showed no complications.
The mortality of intracranial complications such as cerebellar abscess, brain abscess, meningitis and sigmoid sinus thrombosis has decreased recently due to the availability of the preantibiotic treatment. However, typical symptoms are often masked by proceeding antibiotic therapy and it is important to reduce mortality from otogenic complications by early diagnosis and precise treatment in the early stage.