CEREBELLAR ABSCESS IN ANTIBIOTIC ERA, SECONDARY TO CHRONIC OTITIS MEDIA

INTRODUCTION - The incidence and prevalence of complications related to otitis are now diminished. Chronic otitis media is much more likely to cause brain abscess than acute otitis media, and cholesteatoma now accounts for most cases. CASE REPORT - I am reporting a case of 58 year old male, a manual labourer with right ear discharge for 3 years and hard of hearing for 6 months. He was admitted in an outside hospital 2 months ago with right cerebellar hemisphere abscess for which burr hole and evacuation was done and referred to us. On clinical examination, mucopurulent discharge in the right external auditory canal, perforation of tympanic membrane with posterosuperior granulation and severe mixed hearing loss. High Resolution Computed Tomography of temporal bone shows soft tissue opacification in right middle ear and mastoid with partial erosion of ossicles and erosion of posterior wall of petrous part of temporal bone. Modified radical mastoidectomy with Type III tympanoplasty was done with intra-operative finding of polypoidal mass in attic region and the middle ear cavity filled with polypoidal mucosa and granulation tissue. Incus and malleus except its head were found eroded. CONCLUSION - Early diagnosis of intracranial complications is the paramount to enable optimal intervention and to relieve patient symptoms and prevent further complications.