# 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.

## Key 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.