Complications of chronic cholesteatomatous otitis media: about eight cases

A total of 156 cases of the middle ear cholesteatoma treated in our ENT department since 2005, 8 patients presented for the first time for cholesteatomatous complications (5.13% of cases). Intracranial complications in three patients (37.5%), intrapetrous in two patients (25%), extrapetrous in two cases (25%), intra- and extracranial in one patient (12.5%). Children represent 37.5% of cases (three cases), adults under 30 represent 37.5% of cases (three cases), two cases are over 30 years old (25%). Two patients had more than one complication (25%). Radical mastoidectomy was performed for Bezold's abscess, Tympanoplasty with canal wall down was performed for all four patients with intracranial abscess and tympanoplasty with canal wall up was performed in three situations (labyrinthine fistula, facial paralysis and temporo-zygomatic abscess). The cholesteatoma excision was performed simultaneously at, the evacuation of the intracranial abscess in only one case, the drainage of extracranial abscesses in two cases, the repair of the bone defect concerning the facial palsy and the labyrinthine fistula; it was also carried out in a deferred manner in three situations of intracranial complications. The microorganism was isolated in two cases. Mortality in this series was estimated at 12.5%.