title: Lethal cholesteatoma.
abstract: Aural cholesteatoma is a disease entity well known to the otologic community. Complications of cholesteatoma, although uncommon, are not usually life threatening. We present two cases in which a unique and hitherto unreported pathway of spread of a cholesteatoma is noted. The cholesteatoma, after originating in the ear, entered the diploë and spread insidiously between the inner and outer tables to distal parts of the skull. Osteomyelitis, in concert with the cholesteatoma, destroyed large areas of the skull in both patients. One patient died of his disease. The other patient was operated on and is alive but has unresectable disease and purulent drainage from three separate cranial fistulas.
mesh_terms: D000368:Aged; D002781:Cholesteatoma / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D004427:Ear Diseases / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis / Q000000981:diagnostic imaging; D010020:Osteonecrosis / Q000175:diagnosis / Q000209:etiology; D011859:Radiography; D012886:Skull / Q000473:pathology / Q000601:surgery