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Year : 2015  |  Volume : 21  |  Issue : 1  |  Page : 67-71

Bezold's fistula: An unusual presentation of cholesteatoma

Department of Otolaryngology and Head and Neck Surgery, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain

Correspondence Address:
Busaiteen Viresh Arora
Flat No 74, Building 2354, Street 2834, Zip Code 228 Muharaq, Busaiteen
Kingdom of Bahrain
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0971-7749.152873

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Cholesteatoma presenting with a Bezold's fistula is extremely rare, and such presentation has been reported. It is infrequent these days in this era of antibiotics, due to early institution of treatment. Fistula results in untreated and inadequately managed Bezold's abscess. The treatment of Bezold's abscess is with prompt intravenous antibiotics, followed by drainage of cervical abscess, but management that of Bezold's fistula is primarily surgical in which a mastoidectomy is done to eradicate the disease with exposure of the mastoid tip with laying open the fistulous tract. One such unusual case of a Bezold's fistula with cholesteatoma is reported in a teenager with a long-standing history of ear discharge, but without any other complications. The patient had being managed conservatively with ear drops since childhood. High resolution computed tomography (CT) mastoids revealed extensive cholesteatoma is destroying the mastoid and perforating the tip with erosion of the tegmen tympani with extra cranial extension. Patient underwent modified radical mastoidectomy with reconstruction of the mastoid bowl with bone pate. Patient was successfully treated and was followed to 1-year with CT scan without recurrence.

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