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Updated: Jun 27, 2026

Endaural Endoscopic Atticoantrotomy (Retrograde Mastoidectomy) using a Constant Suction Bone-drilling Technique
Published on: May 23, 2021
Aspergillus mastoiditis, presenting with unexplained progressive otalgia, in an immunocompetent (older) patient
Aukje van Tol1, Jeroen van Rijswijk
1Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
Abstract:
Aspergillus mastoiditis and skull-base osteomyelitis are extremely rare, even in immunocompromised patients. We report a case of an 81-year-old immunocompetent man, who underwent a mastoidectomy because of unexplained, progressive otalgia in spite of a noninflamed and air-containing middle-ear space. Histopathology yielded Aspergillus fumigatus. When confronted with otitis with an unexpected clinical course a high index of suspicion is required to facilitate early diagnosis and appropriate therapy of a potential lethal Aspergillus infection, even in immunocompetent patients. This seems to be more so in older patients with an open middle-ear cavity and/or when there is facial nerve involvement.
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