Traumatic cholesteatoma presenting as a brain abscess: a case report.

ABSTRACT

OBJECTIVE: To discuss the clinical aspects and management of traumatic cholesteatomas of the temporal bone. STUDY DESIGN: Case report. SETTING: University hospital, tertiary referral center. PATIENT, INTERVENTION, AND RESULTS: The authors describe an uncommon case of otogenic brain abscess resulting from an infected cholesteatoma arising from an old temporal bone fracture line involving the external auditory canal in an otherwise healthy 21-year-old man. The patient was successfully treated with brain abscess drainage, tympanomastoidectomy, and broad-spectrum intravenous antibiotic therapy. CONCLUSIONS: The authors recommend long-term follow-up in any patient with a longitudinal or mixed temporal bone fracture with low threshold for obtaining temporal bone computer tomography imaging for any new otologic complaints. Traumatic cholesteatomas complicated by brain abscess should be treated with broad-spectrum intravenous antibiotic therapy and aggressive surgical intervention.