Carcinoma of temporal bone presenting as malignant otitis externa

1992 ◽  
Vol 106 (10) ◽  
pp. 908-910 ◽  
Author(s):  
B. A. Al-Shihabi
Keyword(s):  
Otitis Externa ◽  
Facial Nerve Palsy ◽  
Cranial Nerves ◽  
Ear Canal ◽  
End Of Treatment ◽  
Malignant Otitis Externa ◽  
Parotid Swelling ◽  
History Of ◽  
Post Mortem Findings ◽  
The Right

AbstractA 69-year-old man presented with a three-month history of otalgia and tenderness of the right ear and a one-week history of a painful right parotid swelling. Examination revealed granulation tissue in the right ear canal with normal looking tympanic membranes and a parotid abscess. Repeated biopsies from the ear canal and parotid showed non-specific inflammation. Repeated cultures from both areas grew Ps. aeruginosa. The patient's condition improved following three weeks of intensive treatment for malignant otitis externa only to relapse five weeks after the end of treatment. He received a second course, only to improve temporarily. He developed a right facial nerve palsy five weeks after he was first seen, followed four months later by palsies of all cranial nerves except the olfactory, before dying, seven months after his first appointment.The radiological, histological and post-mortem findings are discussed.

scholarly journals 651. Comparative Analysis Between Bacterial And Fungal Malignant Otitis Externa

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S383-S384
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Fatma Smaoui ◽  
Khaoula Rekik ◽  
...  
Keyword(s):  
Otitis Externa ◽  
Clinical Presentation ◽  
The Elderly ◽  
Causative Organism ◽  
Diabetic Patients ◽  
Duration Of Treatment ◽  
Evolutionary Features ◽  
Significant Difference ◽  
Malignant Otitis Externa ◽  
History Of

Abstract Background Malignant otitis externa is a fatal infection of the external ear and temporal bone. Pseudomonas aeruginosa is the most common causative organism, while fungi are a rare cause of malignant otitis externa. We aimed to compare the clinical, therapeutic and evolutionary features between bacterial and fungal malignant otitis externa. Methods We conducted a retrospective study including all patients hospitalized for malignant otitis externa in the infectious diseases department between 2000 and 2018. Results Overall, we encountered 82 cases of malignant otitis externa, among which there were 54 cases (65.9%) of bacterial malignant otitis externa (BMO) and 28 cases (34.1%) of fungal malignant otitis externa (FMO). The males were predominant among BMO cases (57.4% vs 50%; p=0.5). Patients with FMO were significantly older (70±9 years vs 61±10 years; p< 0.001) and had medical history of diabetes mellitus more frequently (96.4% vs 77.8%; p=0.03). The use of topical corticosteroids was significantly more reported among FMO cases (28.6% vs 5.6%; p=0.006). Otalgia (96.4% vs 81.5%), otorrhea (75% vs 66.7%) and cephalalgia (46.4% vs 42.6%) were the revealing symptoms among FMO and BMO, respectively, with no significant difference. Tenderness to palpation of the mastoid bone (64.3% vs 38.9%; p=0.02) and stenosis of the external auditory canal (92.9% vs 72.2%; p=0.02) were significantly more frequent among FMO cases. Complications were significantly more frequent among FMO cases (42.9% vs 9.3%; p< 0.001). Treatment duration was significantly longer among FMO cases (70[40-90] days vs 45[34-75] days; p=0.03). Conclusion Our study showed that FMO affected more frequently the elderly and diabetic patients, when compared with BMO. Regardless of the causative agent, the clinical presentation was similar. However, the outcome was poor among FMO cases with the occurrence of complications, requiring a longer duration of treatment. Disclosures All Authors: No reported disclosures

scholarly journals Extreme Lateral Supracerebellar Infratentorial Approach to the Lateral Midbrain

2018 ◽  
Vol 79 (S 05) ◽  
pp. S415-S417
Author(s):  
M. Kalani ◽  
William Couldwell
Keyword(s):  
Cranial Nerves ◽  
Sudden Onset ◽  
Superior Cerebellar Artery ◽  
Entry Zone ◽  
Cerebellar Artery ◽  
Sensory Disturbances ◽  
History Of ◽  
Supracerebellar Infratentorial Approach ◽  
The Right ◽  
Piecemeal Resection

This video illustrates the case of a 52-year-old man with a history of multiple bleeds from a lateral midbrain cerebral cavernous malformation, who presented with sudden-onset headache, gait instability, and left-sided motor and sensory disturbances. This lesion was eccentric to the right side and was located in the dorsolateral brainstem. Therefore, the lesion was approached via a right-sided extreme lateral supracerebellar infratentorial (exSCIT) craniotomy with monitoring of the cranial nerves. This video demonstrates the utility of the exSCIT for resection of dorsolateral brainstem lesions and how this approach gives the surgeon ready access to the supracerebellar space, and cerebellopontine angle cistern. The lateral mesencephalic safe entry zone can be accessed from this approach; it is identified by the intersection of branches of the superior cerebellar artery and the fourth cranial nerve with the vein of the lateral mesencephalic sulcus. The technique of piecemeal resection of the lesion from the brainstem is presented. Careful patient selection and respect for normal anatomy are of paramount importance in obtaining excellent outcomes in operations within or adjacent to the brainstem.The link to the video can be found at: https://youtu.be/aIw-O2Ryleg.

Glomus tympanicum chemodectoma: unusual radiological findings

1994 ◽  
Vol 108 (7) ◽  
pp. 607-609 ◽  
Author(s):  
Abduljabbar Alshaikhly ◽  
Abdalla M. Hamid ◽  
Bahram Azadeh
Keyword(s):  
Middle Ear ◽  
Malignant Tumour ◽  
Canal Wall ◽  
Ear Canal ◽  
Radiological Findings ◽  
Glomus Tympanicum ◽  
History Of ◽  
One Year ◽  
The Right ◽  
Temporal Bones

AbstractA 64-year-old Qatari female, with a one-year history of right otorrhoea and deafness, had a reddish-white mass projecting into the right ear canal, through the tympanic membrane, that proved histopathologically to be a paraganglioma. Computerized tomography (CT) of the temporal bones showed extensive destruction of the right mastoid bone, the posterior ear canal wall, and the sinus plate, with total disruption of the ossicles, simulating a malignant tumour, which is unusual for a middle ear paraganglioma.

scholarly journals A Forty Five Years Female Patient with Sclerosteosis

1970 ◽  
Vol 11 (2) ◽  
pp. 207-211
Author(s):  
Shamim Ahmed ◽  
Md Abdul Kader ◽  
Quazi Mamtaz Uddin Ahmed ◽  
Abu Shahin ◽  
Md Abul Kalam Azad ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Autosomal Recessive ◽  
Facial Nerve Palsy ◽  
Cranial Nerves ◽  
Autosomal Recessive Disorder ◽  
Final Diagnosis ◽  
Radiological Findings ◽  
The Face ◽  
Van Buchem Disease ◽  
The Right

Sclerosteosis is a rare autosomal recessive disorder, characterized by progressive, generalized bony overgrowth of thecalvarium and mandible with cranial nerve entrapment and raised intracranial pressure, and abnormalities of thedigits. Due to narrowing of the foramina of the cranial nerves, facial nerve palsy, hearing loss and atrophy of the opticnerves can occur. It is clinically and radiologically very similar to van Buchem disease, both of which shows generalizedhyperostosis and sclerosis leading to a markedly thickened and sclerotic skull, with mandible, ribs, clavicles and alsolong bones. Van Buchem disease is differentiated from sclerosteosis by the absence of hand malformations and alarge stature. Here we describe a case of a 45 years-old-female presented with progressive enlargement of right sideof mandible, continuous pain in the right side of the face, right sided lower motor type of facial palsy, bilateral sensoryneural type of hearing loss along with polydactyly and syndactyly. The final diagnosis of sclerosteosis was made byclinical features and radiological findings and exclusion of other causes of hyperosteosis. The particular interest of thispaper is to present a case of sclerosteosis, and to demonstrate the differences between that entity and other sclerosingdiseases of bone.Keywords: Sclerosteosis; van Buchem disease; HyperosteosisDOI: 10.3329/jom.v11i2.5477J MEDICINE 2010; 11 : 207-211

scholarly journals Angiographically occult vascular malformation of the intracranial accessory nerve: case report

2016 ◽  
Vol 125 (1) ◽  
pp. 167-172
Author(s):  
Sergei Terterov ◽  
Nancy McLaughlin ◽  
Harry Vinters ◽  
Neil A. Martin
Keyword(s):  
Vascular Malformation ◽  
Vascular Malformations ◽  
Cranial Nerves ◽  
Final Diagnosis ◽  
Brain Parenchyma ◽  
Accessory Nerve ◽  
Not Otherwise Specified ◽  
History Of ◽  
The Right ◽  
Cerebral Vascular Malformations

Angiographically occult cerebral vascular malformations (AOVMs) are usually found in the supratentorial brain parenchyma. Uncommonly, AOVMs can be found within the cavernous sinus or basal cisterns and can be associated with cranial nerves. AOVMs involving the intracranial segment of the spinal accessory nerve have not been described. A 46-year-old female patient presented with a history of episodic frontal headaches and episodes of nausea and dizziness, as well as gait instability progressing over 6 months prior to evaluation. Imaging revealed a well-circumscribed 3-cm extraaxial T1-weighted isointense and T2-weighted hyperintense contrast-enhancing mass centered in the region of the right lateral cerebellomedullary cistern. The patient underwent resection of the lesion. Although the intraoperative appearance was suggestive of a cavernous malformation, some histological findings were atypical, leading to the final diagnosis of vascular malformation, not otherwise specified. The patient’s postoperative course was uneventful with complete resolution of symptoms. To the authors’ knowledge, this is the first report of an AOVM involving the intracranial portion of the accessory nerve. For any AOVM located within the cerebellomedullary cistern or one suspected of involving a cranial nerve, the authors recommend including immunohistochemistry with primary antibody to neurofilament in the histopathology workup.

scholarly journals Retrosigmoid approach for resection of petrous apex meningioma

2014 ◽  
Vol 36 (v1supplement) ◽  
pp. 1 ◽  
Author(s):  
Daniel G. de Souza ◽  
Leo F. S. Ditzel Filho ◽  
Girma Makonnen ◽  
Matteo Zoli ◽  
Cristian Naudy ◽  
...  
Keyword(s):  
Cranial Nerves ◽  
Retrosigmoid Approach ◽  
Petrous Apex ◽  
Total Removal ◽  
Who Grade ◽  
Facial Numbness ◽  
The Face ◽  
History Of ◽  
The Right ◽  
Neurologically Intact

We present the case of a 50-year-old female with a 1-year history of right-side facial numbness, as well as an electric shock-like sensation on the right-side of the face and tongue. She was previously diagnosed with vertigo and trigeminal neuralgia. MRI was obtained showing a large right cerebellopontine angle mass. A retrosigmoid approach was performed and total removal was achieved after dissection of tumor from brainstem and cranial nerves IV, V, VI, VII and VIII. Pathology confirmed the diagnosis of a meningioma (WHO Grade I). The patient was discharged neurologically intact on the third postoperative day free of complications.The video can be found here: http://youtu.be/-tR0FtMiUDg.

scholarly journals Kawasaki disease manifesting as bilateral facial nerve palsy and meningitis: a case report and literature review

2019 ◽  
Vol 47 (8) ◽  
pp. 4014-4018 ◽  
Author(s):  
Bo Zhang ◽  
Yunpeng Hao ◽  
Yanfeng Zhang ◽  
Nuo Yang ◽  
Hang Li ◽  
...  
Keyword(s):  
Case Report ◽  
Kawasaki Disease ◽  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Brain Magnetic Resonance Imaging ◽  
Neurological Complications ◽  
Appropriate Treatment ◽  
History Of ◽  
The Right

Background Kawasaki disease (KD) is an acute multisystem vasculitic syndrome that predominantly affects infants and young children. Neurological complications are rare in patients with KD and the diagnosis is challenging. We report a case of KD that manifested as bilateral facial nerve palsy and meningitis. Case report A 6-month-old boy presented with a 10-day history of fever. Four days before admission, the patient developed a rash, conjunctival injection, perioral and perianal excoriation, and bilateral facial nerve palsy. Brain magnetic resonance imaging was normal. Echocardiography showed dilated coronary arteries and coronary artery aneurysms. A cerebrospinal fluid examination showed an elevated leukocyte count. A diagnosis of KD was made, and the patient was treated with gamma globulin and aspirin. The patient’s fever subsided on the following day and the right-sided facial nerve palsy was relieved 1 month later. An 18-month follow-up showed that the left-sided facial nerve palsy persisted and the patient’s condition remained stable. Conclusion KD manifesting as bilateral facial nerve palsy and meningitis is extremely rare. Clinicians should be aware of this condition, and early diagnosis and appropriate treatment should be emphasized.

scholarly journals Metastasis of Colonic Adenocarcinoma to the External Ear Canal: An Unusual Case with a Complex Pattern of Disease Progression

2005 ◽  
Vol 84 (1) ◽  
pp. 36-38 ◽  
Author(s):  
Henry J. Carson ◽  
Jeffrey S. Krivit ◽  
Stanley G. Eilers
Keyword(s):  
Hearing Loss ◽  
White Male ◽  
Previous History ◽  
External Ear ◽  
Ear Canal ◽  
External Ear Canal ◽  
History Of ◽  
Adenocarcinoma Of The Colon ◽  
Imminent Death ◽  
The Right

We report on a patient who developed far-ranging metastases of adenocarcinoma of the colon that followed a gradual cephalad progression, including the right external ear canal, and led to hearing loss. The patient was a 63-year-old white male with stage III adenocarcinoma of the colon. After 2 years with metastases elsewhere, he developed hearing loss on the right side. Physical examination of the head and neck showed a mass in the external ear canal, and biopsy confirmed adenocarcinoma. After removal, the patient's hearing improved. This case is interesting not only because of the unusual metastasis to the external ear canal, but also because of the patient's previous history of metastasis over the course of more than 2 years. The significance of such wide-ranging metastases is that metastasis of adenocarcinoma to the ear did not signal imminent death, and relief of the hearing loss it caused was possible.

scholarly journals Ceruminous adenoma mimicking otitis externa

2018 ◽  
Vol 6 ◽  
pp. 2050313X1877714 ◽  
Author(s):  
Uzdan Uz ◽  
Ayca Tan ◽  
Onur Celik
Keyword(s):  
External Auditory Canal ◽  
Otitis Externa ◽  
Rare Condition ◽  
Ear Canal ◽  
Ceruminous Adenoma ◽  
The Right ◽  
Disease Free

Ceruminous adenoma is an extremely rare condition that arises in the external auditory canal. The right ear canal in a 32-year-old man was obstructed by a ceruminous adenoma mimicking otitis externa and its symptoms. The lesion was resected under microscopic view using a transcanal approach. There were no tumor-related symptoms postoperatively and he has been disease free for 1 year after surgery.

scholarly journals Fungal Malignant Otitis Externa with Facial Nerve Palsy: Tissue Biopsy Aids Diagnosis

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Jenny Walton ◽  
Chris Coulson
Keyword(s):  
Otitis Externa ◽  
Facial Nerve Palsy ◽  
Antifungal Drugs ◽  
Tissue Sampling ◽  
Tissue Biopsy ◽  
Malignant Otitis Externa ◽  
Threatening Condition ◽  
Life Threatening ◽  
Low Sensitivity ◽  
Aids Diagnosis

Fungal malignant otitis externa (FMOE) is a serious and potentially life-threatening condition that is challenging to manage. Diagnosis is often delayed due to the low sensitivity of aural swabs and many antifungal drugs have significant side effects. We present a case of FMOE, where formal tissue sampling revealed the diagnosis and the patient was successfully treated with voriconazole, in addition to an up to date review of the current literature. We would recommend tissue biopsy of the external auditory canal in all patients with suspected FMOE in addition to routine microbiology swabs.

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