Title
Extensive skull base cholesteatoma and concurrent fungal infection: A literature review and case report
Background
Cholesteatoma is non-neoplastic disease characterised by the proliferation of keratinising non-nucleated squamous cells within the middle ear and surrounding area. It has a reported incidence of 9 to 12.6 cases per 100,000 adults1.
Objectives 
To increase knowledge around the management of skull base cholesteatoma with concurrent fungal infection acutely and long-term.
Methods
A literature review was conducted and the patient’s presentation, diagnosis and management was assessed.
Results
The literature showed a range in presentation and management of skull base cholesteatoma2-4.  The patient presented with pain, discharge and hearing loss. Investigated with CT, MRI and microbiology swabs. A giant skull base cholesteatoma with concurrent fungal Absidia Corymbifera infection was diagnosed. Surgical exploration and clear-out successfully treated symptoms.
Conclusion
Skull Base cholesteatoma can develop over decades and can present without neurological deficit. A concurrent fungal infection may not be pathogenic. Successful management with lateral approach ear exploration followed by regular outpatient review and microsuction is possible.