目的：探讨乳突根治术后发生耳源性脑脓肿的原因及其防治。方法：对５例患者的有关临床资料进行分析。结果：首次乳突根治术病变清理不彻底、手术操作不规范，乳突腔封闭成型术适应证掌握不当导致术后胆脂瘤残存或复发为颅内合并症的发生原因。结论：须再行乳突根治术治疗。应准确判断病变范围，选择适当手术入路，准确识别残留的重要解剖标志。彻底开放所有气房，清理病变，保留足够宽敞的外耳道，可防止复发。 Objective: To investigate the causes and prevention of otogenic brain abscess after radical mastectomy. Methods: The clinical data of 5 patients were analyzed. Results: The first radical mastoidectomy lesions are not completely cleared, the operation is not standardized, mastoidectomy indications inappropriate lead to postoperative residual or recurrence of cholesteatoma causes of intracranial complications. Conclusions: Radical mastectomy is required. Should be accurately determine the scope of the lesion, select the appropriate surgical approach, accurately identify the residual important anatomical landmarks. Thoroughly open all the air rooms, clean the lesions, keep enough spacious external auditory canal to prevent recurrence.