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Recurrent Cholesteatoma with Skull Base Erosion: A Case Report
Abdulrahman Alosaimi1, Ibrahim A Tawfiq2, Naeem Makhdoom3,1
1Otolaryngology-Head and Neck Surgery, Ohud Hospital, Madinah, SAU.
Cureus
|March 25, 2025
Summary
Recurrent cholesteatomas can cause severe ear destruction and complications like acute mastoiditis. Early diagnosis and surgical intervention are crucial for managing this non-malignant disease and preventing dangerous consequences.
Area of Science:
- Otolaryngology
- Neurosurgery
- Medical Imaging
Background:
- Cholesteatomas are non-malignant, destructive growths in the middle ear and temporal bone.
- Untreated cholesteatomas can lead to severe complications, including skull base destruction and brain abscess.
- Recurrence necessitates vigilant monitoring and timely intervention.
Observation:
- A 30-year-old male presented with acute mastoiditis, ear pain, swelling, fever, and purulent discharge.
- Examination revealed postauricular swelling, redness, and a mass in the stenosed external auditory canal.
- The patient had a history of cholesteatoma surgery 14 years prior, with recurrent disease and skull base erosion.
Findings:
- Audiogram showed a 35 dB conductive hearing loss in the right ear.
- CT, MRI, and brain angiogram revealed mastoid and temporal bone destruction, skull base defects, and jugular vein encasement.
- The patient underwent revision tympanomastoidectomy with skull base reconstruction.
Implications:
- This case highlights the importance of early diagnosis and comprehensive imaging for cholesteatoma management.
- Prompt surgical intervention is vital to prevent complications like cerebrospinal fluid leaks and intracranial infections.
- Effective management strategies are essential to avoid catastrophic outcomes from recurrent cholesteatoma disease.
