Temporal bone histopathology is reported on a case of acute suppurative otitis media, acute suppurative labyrinthitis, and meningitis with death of the patient 20 days after stapes surgery. Purulent exudate invaded the vestibule by the oval window through a displaced footplate. The main pathway of infection to the meninges was extension along the branches of the vestibular nerve to the internal auditory meatus and to the subarachnoid space.