Cholesteatoma Complicated by Parapharyngeal Abscess That Occurred After Temporal Bone Fracture

TL;DR

A rare case of parapharyngeal abscess following a temporal bone fracture in a patient with chronic otitis media and cholesteatoma is reported, highlighting a possible infection spread route.

Contribution

This case report presents a rare complication of chronic otitis media with cholesteatoma following head trauma.

Findings

A 65-year-old man developed a parapharyngeal abscess after a temporal bone fracture.

Imaging suggested infection spread through bone fracture defects to the parapharyngeal space.

The patient recovered after surgical intervention despite postoperative septic shock and acute renal failure.

Abstract

Parapharyngeal abscess as a cervical complication of chronic otitis media with cholesteatoma is extremely rare. We present the case of a patient with chronic otitis media and cholesteatoma who developed a parapharyngeal abscess following a blunt head trauma. A 65-year-old man with a history of recurrent right purulent otorrhea presented with symptoms of profuse purulent otorrhea, headache, hoarseness, and difficulty swallowing. Imaging revealed the presence of a right parapharyngeal abscess alongside a temporal bone fracture, suggesting a potential direct spreading route of aggressive chronic suppurative otitis media infection through the bone fracture defects to the parapharyngeal space. The patient underwent abscess drainage via a transcervical approach with simultaneous emergency radical mastoidectomy. Despite the development of septic shock with acute renal failure in the postoperative period, the patient made a full recovery.

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