Bezoldʹs abscess arising with recurrent cholesteatoma 20 years after the first surgery: with a review of the 18 cases published in Japan since 1960

The classic Bezoldʹs abscess was described as a deep neck abscess arising from an acute mastoiditis. With the pervasive use of antibiotics, the incidence of otitic suppurative complications including Bezoldʹs abscess has dramatically decreased today. This decreased incidence has led to decreased familiarity and a subsequent increased delay in diagnosis. Otolaryngologists must recognize that intervening in benign processes such as cholesteatoma can lead to unforeseen serious complications. A case of Bezoldʹs abscess arising in a 25-year-old man with recurrent cholesteatoma 20 years after his first surgery is presented. In this patient despite the prior canal wall down tympanoplasty, granulation tissue blocked the pathway from the mastoid to the external auditory meatus. A cholesteatoma formed in this obstructed space became secondarily infected and filled the mastoid cavity with pus. This recent clinical presentation of Bezoldʹs abscess is described and the Japanese literature reviewed to renew familiarity with this rare complication.