A case of ear canal stenosis complicated by cholesteatoma developing into Bezold’s abscess

Abstract

Bezold’s abscess is a neck abscess that was first described by Friedrich Bezold as a complication of mastoiditis in 1881. Since the advent of antibiotics, cases of Bezold’s abscess caused by suppurative otitis media have diminished significantly and those occurring as a rare complication of cholesteatoma and chronic otitis media have increased. We present a rare case of left ear canal stenosis complicated by middle ear cholesteatoma developing into Bezold’s abscess. A 62-year-old man visited the emergency department of our hospital with complaints of fever and anorexia. His bilateral external ear canals were almost obliterated, resulting from chronic external otitis. The left postauricular region and posterior part of the neck were markedly swollen. Based on the physical examination findings and computed tomography scan of the temporal bone and neck, he was diagnosed with Bezold’s abscess. After admission, the patient underwent emergent drainage of the left neck abscess through a neck incision, and was treated with intravenous antibiotics. After approximately a month, he underwent left radical tympano-mastoidectomy and meatopasty. The left external ear canal showed bony stenosis, and cholesteatoma was found filling the interior side of his left canal, tympanic cavity, antrum, and mastoid tip. There was no sign of recurrence during the 80-month follow-up period.