Abstract
An 86-year-old man with type 2 diabetes who underwent middle ear surgery for otitis media in his childhood was referred to our hospital with a complaint of left otalgia. Local findings and imaging diagnoses revealed non-neoplastic granulomatous tissues continued from the external auditory canal to the tympanic cavity, inflammation with abscess extending from the middle ear cavity to the infratemporal fossa and dural thickening. No pathogenic bacteria including acid fast bacteria were detected by a bacteriological examination, and systemic inflammatory diseases including granulomatous polyangitis were not suggested by blood biochemical analysis. The histopathological diagnosis also showed non-specific inflammatory granuloma. Based on these findings, this patient was diagnosed as having inflammatory middle ear disease due to long-term interruption of medical treatment by an otologist after the middle ear surgery. The disease responded poorly to antibiotics but improved by the systemic administration of glucocorticoids. An otological examination showed improvement of disease but he died of inflammatory bowel disease.
