scholarly journals Anomalous Facial Nerve in a Case of Atticoantral Chronic Otitis Media with Mastoid Abscess

2021 ◽  
Vol 10 (31) ◽  
pp. 2525-2527
Author(s):  
Ajinkya Maruti Sandbhor ◽  
Prasad T. Deshmukh ◽  
Sagar Shankarrao Gaurkar ◽  
Arjun Saini

An 18 years old female patient came to emergency medicine department on 3rd July 2020 in the evening hours with massive swelling extending in front, above and behind left ear. Associated with severe, throbbing, intermittent headache since past 4 days patient also had high grade fever. Patient also had a history of left ear foul smelling discharge, scanty in amount, non-blood tinged, not aggravated or relieved with upper respiratory tract infection (URTI), not relieved with medications and not associated with giddiness. Clinical examination revealed a swelling in left preauricular region extending to temporoparietal region displacing left pinna downwards and outwards. Bilateral periorbital swelling was present (Figure 2, 3). Mastoid tenderness was conspicuous. Whitish foul smelling, non-blood-tinged discharge was present in left external auditory meatus. Further ear examination was not possible due to oedema, swelling and thick discharge in external auditory canal (EAC). In view of extensive swelling with its epicenter in mastoid region, left unsafe chronic otitis media (COM) with complication was suspected and was admitted to ENT ward. General investigations were normal except leucocytosis. While patient was put on antibiotics, neurosurgical opinion was sought and magnetic resonance imaging (MRI) brain with contrast was planned to map the abscess. MRI (Figure 1) which was suggestive of left squamosal COM and mastoiditis with intracranial extradural abscess in left temporoparietal region. MRI also uncovered large subgaleal abscess in the left temporo-occipito-parietal region along the sternocleidomastoid (SCM) muscle with thrombosis of left transverse and sigmoid sinus. Neurosurgeons found no need for intervention from their side.

PEDIATRICS ◽  
1979 ◽  
Vol 63 (3) ◽  
pp. 435-442
Author(s):  
Jessie R. Groothuis ◽  
Sarah H. W. Sell ◽  
Peter F. Wright ◽  
Judith M. Thompson ◽  
William A. Altemeier

Ninety-one normal infants were followed longitudinally for varying periods from November 1975 to April 1977 to assess the correlation between tympanometry and pneumatic otoscopy and to study the pathogenesis of acute and chronic otitis media early in life. Type A (normal) tympanograms correlated with normal otoscopic findings in 92% of instances. Type B tympanograms, indicating reduced drum compliance with a relatively flat pressure curve, were associated with abnormal otoscopic findings in 93% of cases. The A8 (reduced compliance, normal pressure) and C (normal compliance, negative pressure) tympanograms were less consistent predictors of otoscopic findings. The correlation of tympanometric and otoscopic findings were similar in infants above and below 7 months of age. Tympanometry provided some insight into the natural history of otitis in 71 infants followed 12 to 17 months. Infants who failed to develop otitis had type B curves in only one of 240 determinations (0.4%). This pattern did not appear in those who developed acute otitis media (AOM) until the month preceding the first attack; nine of 29 tests (31%) made under these circumstances were type B. When a type B curve appeared in an asymptomatic study infant who had not previously had otitis, AOM developed within a month in nine of ten instances. At the time of diagnosis of first AOM, 87% of tympanograms were type B with the remainder type A8 or C. Sixty-three percent of tympanograms obtained from 25 infants during the six months following first AOM were type B, indicating that abnormal middle ear function was often prolonged. Fifteen of these 25 developed recurrent otitis during follow-up.


Author(s):  
Prashanth Kudure Basavaraj ◽  
Manjunatha H. Anandappa ◽  
Nishtha Sharma ◽  
Shreyas Karkala ◽  
Veena Prabhakaran

<p>Myiasis is the infestation by fly larvae. There are few sporadic publications regarding human ear myiasis. Osteomyelitis of temporal bone is also an uncommon entity. This study aims to describe the clinical presentation and management of a unique presentation of mastoid cavity myiasis and sequestration in a 4 year old child, who presented to Chigateri district hospital, Davangere with blood tinged discharge along with visible maggots from left external auditory canal and post auricular sinus since 3 days, with history of chronic otitis media. After manual cleaning of maggots, high resonance computed tomography of temporal bone was done, which showed findings suggestive of foreign body with bony density. Modified radical mastoidectomy was done, where osteomyelitis of temporal bone with sequestrum was encountered on table and removed. Diagnosis of temporal bone osteomyelitis requires a high degree of suspicion, especially in a setting of myiasis, as these 2 rare pathologies have not been reported to co-occur in literature. Early intervention is essential to avoid fatal complications of this infrequent presentation.</p>


1998 ◽  
Vol 107 (6) ◽  
pp. 486-491 ◽  
Author(s):  
Jan E. Veldman ◽  
W. Weibel Braunius

The objective of this study was to evaluate, during a long-term follow-up period, the results of revision surgery for chronic otitis media with or without cholesteatoma. Intact canal wall and canal wall down procedures were performed. The surgical history of every patient was assessed before the operation. A dry, relatively safe, and disease-free ear was created in 90% of the reoperated ears (N = 389). The recurrence rate of cholesteatoma was 5% for the total group. Reperforations of the tympanic membrane occurred in 10%, and persistent or recurrent otorrhea was present in 10% of cases. The functional hearing results were quite satisfactory. A residual air-bone gap of ≤30 dB was reached in 70.3% of the cases after revision tympanoplasty only (N = 41). Revision mastoidectomy with revision tympanoplasty as a one-stage procedure led subsequently, in 76% of intact canal wall procedures (N = 113) and 55% of canal wall down procedures (N = 98), to a residual air-bone gap of ≤30 dB.


PEDIATRICS ◽  
1980 ◽  
Vol 66 (2) ◽  
pp. 246-253
Author(s):  
Peter W. Zinkus ◽  
Marvin I. Gottlieb

The effects of chronic otitis media during the first three years of life on developing auditory processing skills were examined. Two groups of children with auditory processing deficits were compared in areas of language development, intellectual factors, auditory processing skills, and academic capabilities. One group of children with auditory processing deficits had a history of severe chronic otitis media during the first three years of life, whereas a second group had auditory processing deficits but no history of early middle ear infections. The results indicate that subjects who had a history of chronic otitis media were slower in developing word combinations, had depressed verbal intelligence scores, manifested pervasive auditory processing deficits, and were significantly poorer in reading. A profile has been constructed that permits early detection of the child at risk.


2020 ◽  
pp. 000348942094321
Author(s):  
Ameen Biadsee ◽  
Feda Fanadka ◽  
Or Dagan ◽  
Kassem Firas ◽  
Benny Nageris

Objective: To compare the size of Ostmann’s fat pad (OFP) between healthy ears and ears with chronic otitis media with cholestatoma (COMwC) using magnetic resonance imaging (MRI). Methods: Twenty-six patients with unilateral COMwC underwent mastoidectomy. Pre-operative MRI records were reviewed retrospectively. The healthy ears served as the control group. OFP is represented by the maximum diameter of the high intensity area medial to the tensor veli palatini muscle (TVP); M1. A reference diameter was defined from the medial border of OFP reaching the medial border of the medial pterygoid muscle; M2. Values of M1, M2 and the ratio of M1:M2 was compared between the healthy and pathological ear in each patient. Results: All 26 patients (16 females,10 males) had unilateral cholestatoma. Mean age was 37.6 years (range 19-83). In the healthy (H) ears group, mean M1H was 2.04 ± 0.53 mm, mean M2H was 9.57 ± 2.57 mm. In the pathological (P) ears group; mean M1P was 2.03 ± 0.55 mm, mean M2P was 9.86 ± 2.37 mm. A comparison of M1 and M2 values between the healthy and pathological ear groups was not statistically significant ( P = .853 and P = .509, respectively). Mean M1H:M2H ratio in the healthy ears group was 0.22 ± 0.05, mean M1P:M2P ratio in the pathological ear group was 0.21 ± 0.06. A comparison between these ratios found no significant statistical correlation ( P = .607). Conclusion: The size of Ostmann’s fat pad does not affect the development of chronic otitis media with cholestatoma in adults.


2007 ◽  
Vol 122 (10) ◽  
pp. 1124-1126 ◽  
Author(s):  
N Choudhury ◽  
G Kumar ◽  
M Krishnan ◽  
D J Gatland

AbstractObjective:We report an atypical case of ossicular necrosis affecting the incus, in the absence of any history of chronic serous otitis media. We also discuss the current theories of incus necrosis.Case report:A male patient presented with a history of right unilateral hearing loss and tinnitus. Audiometry confirmed right conductive deafness; tympanometry was normal bilaterally. He underwent a right exploratory tympanotomy, which revealed atypical erosion of the proximal long process of the incus. Middle-ear examination was otherwise normal, with a mobile stapes footplate. The redundant long process of the incus was excised and a partial ossicular replacement prosthesis was inserted, resulting in improved hearing.Conclusion:Ossicular pathologies most commonly affect the incus. The commonest defect is an absent lenticular and distal long process of the incus, which is most commonly associated with chronic otitis media. This is the first reported case of ossicular necrosis, particularly of the proximal long process of the incus, in the absence of chronic middle-ear pathology.


2001 ◽  
Vol 115 (6) ◽  
pp. 444-446 ◽  
Author(s):  
Leonard Berenholz ◽  
William Lippy ◽  
John Burkey ◽  
Arnold Schuring ◽  
Franklin Rizer

The aim of this study was to evaluate the success of stapedectomy in patients who have previously had a tympanoplasty because of chronic otitis media (COM). Fourteen patients from a private otology practice had undergone tympanoplasty for COM and subsequently underwent stapedectomy. Measurements were taken of the air-bone gap (ABG) closure and pure tone average (PTA) which showed hearing improvement. Patients had a mean 36.9 dB PTA hearing gain with 79 per cent closing the ABG to within 20 dB. The need for stapedectomy alone is a rare occurrence for patients with a history of COM requiring a tympanoplasty. Hearing improvement following stapedectomy in these cases was significant, although somewhat less than following traditional stapedectomy in otosclerosis alone.


1998 ◽  
Vol 118 (4) ◽  
pp. 437-443 ◽  
Author(s):  
Griffith S. Hsu ◽  
Samuel C. Levine ◽  
G. Scott Giebink

Increased costs of managing otitis media and its complications may result from delays in diagnosis and treatment. The Agency for Health Care Policy and Research developed guidelines to assist in the management of chronic otitis media with effusion. We examined the medical care adherence to Agency for Health Care Policy and Research guidelines in 59 consecutive patients referred because of chronic otitis media with effusion and recurrent acute otitis media. Patient history and examination data were collected prospectively. In the group with chronic otitis media with effusion, the rate of adherence to Agency for Health Care Policy and Research guidelines was 0%; in those with recurrent acute otitis media, adherence was 5%. Delayed referral occurred in 34% of patients; 25% of patients were referred early. The average duration of effusion in patients with chronic otitis media with effusion was 5.2 months; the duration of recurrent acute otitis media immediately before referral was 9.3 months. Eighteen patients (47%) in the chronic otitis media with effusion group had a history of recurrent chronic otitis media with effusion spanning an average of 22.7 months. On referral, hearing loss was discovered in 92% of all patients, and in 69% the tympanogram was flat. The complication and sequelae rate was 49.1%, and speech delay was the most frequent at 16.9%. We conclude that in our study patients there is a significant referral delay, long history of chronic otitis media with effusion in patients before referral, high rate of hearing loss, and high complication rate. Continued efforts should be directed toward improving education of all clinicians so that diagnostic tools and timely otolaryngologic referral are better used.


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