Benign necrotizing osteitis of the external auditory meatus

AbstractBenign necrotizing osteitis of the external auditory meatus is a rare condition which occurs in non-diabetic healthy people. The aetiology of the necrotic process with the formation of sequestrum in the bony external meatus is unknown. It is important to differentiate this benign process from malignant otitis externa and radionecrosis of the temporal bone as the management of these conditions differs. We present two cases, one managed surgically and the other medically, and review the literature. Immediate surgical excision of the sequestrum is advocated instead of long-term medical therapy and waiting for it to separate spontaneously.

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Surgical management of benign necrotizing otitis externa

The Journal of Laryngology & Otology ◽

10.1017/s0022215100126015 ◽

1994 ◽

Vol 108 (2) ◽

pp. 101-105 ◽

Cited By ~ 5

Author(s):

P. J. Wordmald

Keyword(s):

Differential Diagnosis ◽

Surgical Management ◽

Otitis Externa ◽

Rare Condition ◽

Vascular Supply ◽

External Ear ◽

Unknown Aetiology ◽

Necrotizing Otitis Externa ◽

Malignant Otitis Externa

AbstractBenign necrotizing otitis externa (BNOE) is a rare condition of unknown aetiology which is characterized by the formation of an avascular bony sequestrum of the tympanic plate. The vascular supply of the tympanic plate is easily compromized as demonstrated by the development of avascular necrosis in radionecrosis of the tympanic plate and malignant otitis externa. Recognition of BNOE as distinct from malignant otitis externa and carcinoma of the external ear is important as the treatment differs greatly. BNOE also forms an important part of the differential diagnosis of recalcitrant otitis externa.Management of BNOE has been unclear with long-term medical treatment being advocated. In this series of five patients, the surgical management of four patients with BNOE is described. Surgery was successful in all these patients and is advocated as an alternative to medical management.

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Extracranial meningioma presenting as a tumour of the external auditory meatus: a case report

The Journal of Laryngology & Otology ◽

10.1017/s0022215100136692 ◽

1997 ◽

Vol 111 (2) ◽

pp. 148-151 ◽

Cited By ~ 10

Author(s):

Reiko Tsunoda ◽

Takashi Fukaya

Keyword(s):

Temporal Bone ◽

Rare Case ◽

External Auditory Meatus ◽

Middle Cranial Fossa ◽

External Meatus ◽

Cranial Fossa ◽

Magnetic Resonance Imaging Mri ◽

Extracranial Meningioma ◽

Operative Findings ◽

Intradural Space

AbstractA rare case of extracranial meningioma presenting as a tumour of the external auditory meatus is reported. Biopsy indicated a diagnosis of meningioma, but the radiological appearance was unusual. For example, computed tomography (CT) scans showed an unenhanced tumour mainly located in the squamous part of the temporal bone which expanded into the external meatus destroying the temporal bone. Magnetic resonance imaging (MRI) revealed that the tumour did not extend into the intradural space.This meningioma, had an obvious tendency for extracranial development. According to the operative findings, the tumour arose from the middle cranial fossa dura and extended through the air cells of the temporal bone into the external meatus, instead of growing intracranially.Secondary extracranial meningiomas of the temporal bone usually have a large intracranial component and cause neurological symptoms. However, this was a very rare case of a small meningioma causing no symptoms except for conductive hearing loss.

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Comprehensive management of malignant otitis externa with tuberculosis and cranial nerve paresis in geriatrics

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v50i1.355 ◽

2020 ◽

Vol 50 (1) ◽

pp. 77

Author(s):

Ratna Dwi Restuti

Keyword(s):

Diabetes Mellitus ◽

Temporal Bone ◽

Cranial Nerve ◽

Cranial Nerve Palsy ◽

Otitis Externa ◽

Nerve Palsy ◽

Geriatric Patients ◽

Cranial Nerve Palsies ◽

Malignant Otitis Externa ◽

Multiple Cranial Nerve

Background: Malignant otitis externa is an inflammatory condition of the external ear which has the propensity to spread to the skull base. It can be a difficult entity to treat as clinical presentation varies and response to treatment differs between patients. Purpose: Evaluating the management of malignant otitis externa with complications in geriatric patients who had multiple comorbidities. Case: A 71 years old female with a diagnosis of left malignant otitis externa with complications of multiple cranial nerve palsies (N.VII, IX, X) and comorbidity in the form of diabetes mellitus and chronic kidney disease. The patient underwent subtotal temporal bone resection and petrosectomy. Clinical Question: “Could surgical management of malignant otitis externa with cranial nerve palsies complication in geriatric patients with multiple comorbidities achieve better result than conservative treatment?” Review Method: Literature search using keywords ’malignant otitis externa’ OR ’temporal bone osteomyelitis’ AND ’geriatric’ OR ’elderly’ AND ’multiple cranial nerve palsy’ AND ’diabetes mellitus’ AND ’tuberculosis’ AND ’surgery’ OR ’surgical’ was conducted through Cochrane, Pubmed, and Google Scholar. Result: The search obtained 11 articles published in the last 10 years. Selection based on inclusion and exclusion criteria, 2 studies were found relevant with the topic. Conclusion: Management of malignant otitis externa with complications in geriatric patients with multiple comorbidities requires a multidisciplinary approach to determine the need for surgery intervention.Keywords: malignant otitis externa, cranial nerve palsy, subtotal temporal bone resection, geriatric, diabetes mellitus ABSTRAK Latar belakang: Otitis eksterna maligna adalah suatu kondisi peradangan pada telinga luar yang memiliki kecenderungan untuk meluas hingga ke dasar tengkorak. Penyakit ini menjadi sulit ditangani karena manifestasi klinis yang bervariasi dan respons terhadap pengobatan yang berbeda antara pasien. Tujuan: Mengevaluasi tatalaksana otitis eksterna maligna dengan komplikasi pada pasien geriatri yang memiliki komorbiditas multipel. Kasus: Pasien perempuan 71 tahun dengan diagnosis otitis eksterna maligna telinga kiri dengan komplikasi paresis saraf kranial multipel (n.VII, IX, X) dan penyakit penyerta berupa diabetes melitus dan gagal ginjal kronik. Pasien menjalani operasi reseksi tulang temporal subtotal dan petrosektomi. Pertanyaan klinis: “Apakah tatalaksana pembedahan memberikan hasil yang lebih baik dibandingkan terapi konservatif pada pasien geriatri dengan otitis eksterna maligna disertai paresis saraf kranialis dengan komorbiditas multipel.” Telaah Literatur: Dilakukan menggunakan kata kunci ’malignant otitis externa’ ATAU ’temporal bone osteomyelitis’ DAN ’geriatric’ ATAU ’elderly’ DAN ’multiple cranial nerve palsy’ DAN ’diabetes melitus’ DAN ’tuberculosis’ DAN ’surgery’ ATAU ’surgical’ pada beberapa sumber data seperti Cochrane, Pubmed, dan Google Scholar. Hasil: Didapatkan 11 artikel publikasi 10 tahun terakhir. Berdasarkan kriteria inklusi dan eksklusi diperoleh 2 artikel yang relevan dengan topik. Kesimpulan: Tatalaksana otitis eksterna maligna dengan komplikasi pada pasien geriatri dengan komorbiditas multipel, membutuhkan pendekatan multidisiplin terutama untuk menentukan perlunya dilakukan tindakan pembedahan.

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Immunoglobulin G4 related systemic sclerosing disease involving the temporal bone

The Journal of Laryngology & Otology ◽

10.1017/s0022215110001143 ◽

2010 ◽

Vol 124 (10) ◽

pp. 1106-1110 ◽

Cited By ~ 17

Author(s):

L Masterson ◽

M Martinez Del Pero ◽

N Donnelly ◽

D A Moffat ◽

E Rytina

Keyword(s):

Temporal Bone ◽

Plasma Cells ◽

Rare Condition ◽

Immunohistochemical Analysis ◽

Surgical Excision ◽

Serum Levels ◽

Inflammatory Myofibroblastic Tumour ◽

Inflammatory Pseudotumour ◽

Immunoglobulin G4 ◽

Anaplastic Lymphoma

AbstractObjective:To report a rare condition affecting the temporal bone. Immunoglobulin G4 related systemic sclerosing disease is a recently described autoimmune condition with manifestations typically involving the pancreas, biliary system, salivary glands, lungs, kidneys and prostate. Histologically, it is characterised by T-cell infiltration, fibrosis and numerous immunoglobulin G4-positive plasma cells. This condition previously fell under the umbrella diagnosis of inflammatory pseudotumour and inflammatory myofibroblastic tumour.Case report:We present the case of a 58-year-old woman with multiple inflammatory masses involving the pharynx, gall bladder, lungs, pelvis, omentum, eyes and left temporal bone, over a seven-year period. We describe this patient's unusual clinical course and pathological features, which resulted in a change of diagnosis from metastatic inflammatory myofibroblastic tumour to immunoglobulin G4 related systemic sclerosing disease. We also review the literature regarding the management of inflammatory pseudotumours of the temporal bone, and how this differs from the management of immunoglobulin G4 related systemic sclerosing disease.Conclusion:We would recommend a full review of all histological specimens in patients with a diagnosis of temporal bone inflammatory pseudotumour or inflammatory myofibroblastic tumour. Consideration should be given to immunohistochemical analysis for anaplastic lymphoma kinase and immunoglobulin G4, with measurement of serum levels of the latter. Management of the condition is medical, with corticosteroids and immunosuppression, rather than surgical excision.

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Temporal bone osteomyelitis and temporoparietal abscess secondary to malignant otitis externa

The Journal of Laryngology & Otology ◽

10.1017/s0022215109005313 ◽

2009 ◽

Vol 123 (11) ◽

pp. 1288-1291 ◽

Cited By ~ 4

Author(s):

B Alva ◽

K Chandra Prasad ◽

S Chandra Prasad ◽

S Pallavi

Keyword(s):

Temporal Bone ◽

Otitis Media ◽

World Literature ◽

Otitis Externa ◽

Acute Otitis Media ◽

Suppurative Otitis Media ◽

The Past ◽

Modified Radical Mastoidectomy ◽

Malignant Otitis Externa ◽

Canal Wall Down

AbstractObjective:We report an advanced presentation of osteomyelitis of the temporal bone secondary to malignant otitis externa.Method:We present a case report and a review of the world literature concerning osteomyelitis of the temporal bone secondary to malignant otitis externa.Results:A 60-year-old diabetic man developed osteomyelitis of the temporal bone and a temporoparietal abscess as advanced complications of malignant otitis externa. He was successfully treated in our institution using a post aural incision after draining the abscess and excising the fistula, a modified radical mastoidectomy with canal wall down procedure with sequesterectomy and debridement of surrounding area done.Conclusion:The terms ‘osteomyelitis of the temporal bone’, ‘skull base osteomyelitis’ and ‘malignant otitis externa’ have not been clearly defined, and have in the past often been used interchangeably in the literature. Osteomyelitis of the temporal bone can occur secondary to malignant otitis externa, acute otitis media, chronic suppurative otitis media or trauma. Here, we present the management of an advanced case of osteomyelitis of the temporal bone.

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BILATERAL OSSIFIED STYLOHYOID CHAIN - A CASE STUDY

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1703572 ◽

2012 ◽

Vol 02 (02) ◽

pp. 51-53

Author(s):

Shivarama C. H. ◽

Bhat Shivarama ◽

Radhakrishna Shetty K. ◽

Vikram S. ◽

Avadhani R.

Keyword(s):

Temporal Bone ◽

External Auditory Meatus ◽

Styloid Process ◽

The Other ◽

Normal Length ◽

Inferior Surface ◽

Stylomastoid Foramen ◽

Stylohyoid Ligament ◽

Stylohyoid Chain

AbstractThe styloid process is a slender bony projection that arises from the inferior surface of the temporal bone just beneath the external auditory meatus and closely related to the stylomastoid foramen. The normal length of SP in an adult is considered to be 20 to 30mm however, it is very variably developed, ranging in length from a few millimetres to a few centimetres.The styloid process is developed at the cranial end of cartilage in the second visceral or hyoid arch by two centers: a proximal, for the tympanohyal, appearing before birth; the other, for the distal stylohyal, after birth. But sometimes the stylohyoid chain may form, that extends between the temporal and hyoid bones which are divided into 4 sections: tympanohyal, stylohyal, ceratohyal and hypohyal. Cartilage that is embryo logically located at the stylohyoid ligament may undergo calcification of varying degrees, which causes variations. Ossified stylohyal ligament parts may merge or leave gaps in between. The anatomy of styloid process has immense embryological, clinical, surgical importance.

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Surgical management of extensive hypertrophic scarring of the halluces secondary to a decade of untreated onychocryptosis: An illustrative case report

SAGE Open Medical Case Reports ◽

10.1177/2050313x17740514 ◽

2017 ◽

Vol 5 ◽

pp. 2050313X1774051

Author(s):

Dean J Samaras ◽

Andrew C Kingsford

Keyword(s):

Treatment Options ◽

Rare Condition ◽

Surgical Excision ◽

Current Treatment ◽

Illustrative Case ◽

Hypertrophic Scarring ◽

Psychosocial Effects ◽

Term Outcome ◽

Long Term Outcome

Extensive hypertrophic scarring of the halluces secondary to chronic onychocryptosis is a rare condition, which causes significant physical and psychosocial effects. In this case, a 31-year-old male developed large lesions on both great toes after he delayed treatment of chronic hallucal onychocryptosis for over a decade. Current treatment options for hypertrophic and keloid lesions in the foot and ankle vary considerably and differentiation is critical for appropriate treatment planning. In this case, surgical excision with total matrixectomy (modified Zadik–Syme) was considered optimal management. Histopathology testing confirmed the diagnosis of irritated hypertrophic scar secondary to onychocryptosis. The patient was monitored closely and at 3 months post-operatively, the incisional scars exhibited progressive maturation, and there was no recurrence of the lesions and no nail regrowth. Furthermore, the halluces were only marginally shorter providing good function and cosmesis. At the long-term follow-up consultation (5.5 years), the patient indicated complete satisfaction and had returned to regular footwear and social activities. Chronic onychocryptosis can trigger and facilitate proliferation of large benign keloid-like fibrous lesions; excision with total matrixectomy can provide an excellent long-term outcome.

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Spectrum of radiological appearances of necrotising external otitis: a pictorial review

The Journal of Laryngology & Otology ◽

10.1017/s0022215111001691 ◽

2011 ◽

Vol 125 (11) ◽

pp. 1109-1115 ◽

Cited By ~ 17

Author(s):

P Mehrotra ◽

M R Elbadawey ◽

I Zammit-Maempel

Keyword(s):

Temporomandibular Joint ◽

Temporal Bone ◽

Otitis Externa ◽

Sinus Thrombosis ◽

Sigmoid Sinus ◽

External Otitis ◽

Imaging Findings ◽

Fatal Disease ◽

Pictorial Review ◽

Malignant Otitis Externa

AbstractNecrotising external otitis, also known as malignant otitis externa, is an aggressive, resorptive osteomyelitis of the temporal bone. Although rare, necrotising external otitis is a potentially fatal disease, with complications which include temporomandibular joint osteomyelitis, sigmoid sinus thrombosis and meningitis. Imaging findings may be subtle, particularly in the early stages. We present a broad range of imaging findings which may occur in necrotising external otitis cases.

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