scholarly journals A Case of Temporal Bone Abscess in an Immunocompromised Patient

Author(s):  
Andrew Tan Kie Kion ◽  
Nik Adilah Nik Othman

Introduction: Acute otitis media (AOM) is an otological disease that is usually self-limit ing. However, certain AOM complicates with abscess development over the deep neck cavity (Bezold's abscess), occiptal abscess (Citelli's) or beneath the temporal muscle (Luc's abscess). Luc's abscess was described as a more benign form of AOM that seldom require extensive surgical drainage.Case report: We report a case of a subperiosteal temporal bone abscess in an immunocompromised patient, which resolved with local drainage of abscess and cultureoriented antimicrobial.Conclusion: Luc's abscess is a rare form of the complication of otitis media, associated with relatively lower morbidity, better prognosis, and requires a limited surgical intervention. High resolution computed tomography (HRCT) temporal bone is highly recommended to evaluate the extent of the disease and to decide for further treatment strategy. The choice of surgery should also be tailored to the patient's premorbid factor.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 45

2021 ◽  
Vol 10 (25) ◽  
pp. 1862-1865
Author(s):  
Sanjana Pradeep ◽  
Swaroop Dev ◽  
Jyothi Swarup Raju ◽  
Shravya Pasunuti

BACKGROUND Chronic otitis media (COM) of squamosal type is associated with cholestatoma with potential complications. Clinical examination and high resolution computed tomography (HRCT) scans are necessary to assess the disease site and extension. The purpose of the study was to compare the preoperative HRCT findings with the intraoperative surgical findings in squamosal type of chronic otitis media as well as various parameters in HRCT temporal bone and intraoperative findings. METHODS A prospective study was conducted on 30 patients aged between 18 and 60 years of both the genders who presented with chronic otitis media squamosal type, for a period of 22 months who attended the outpatient department of ENT. RESULTS HRCT findings and intraoperative findings were compared and results were analysed. Facial canal erosion (P - 0.0031), tegmen plate erosion (P - 0.0001), sigmoid sinus plate erosion (P - 0.002) were found to be statistically significant. Lateral semicircular canal fistula (P - 0.36) and ossicular status malleus (P - 1.000), incus (P - 0.949), stapes suprastructure (P - 0.984), and stapes footplate erosion (P - 0.977) were found to be statistically insignificant. CONCLUSIONS In our study, HRCT imaging for COM squamosal type, accurately depicted the soft tissue mass, erosion of tegmen plate, sigmoid sinus plate, scutum, lateral semicircular canal fistula, incus and suprastructure of stapes erosion and the same were found intraoperatively as well. Our study showed good comparison between the preoperative HRCT scans and the surgical findings in cholesteatoma cases. HRCT is confirmed to be valuable in the diagnosis and in guiding the surgical management of cholesteatoma. KEY WORDS Chronic Otitis Media, Cholesteatoma, HRCT Temporal Bone, Modified Radical Mastoidectomy


Author(s):  
Akanksha Dhiman ◽  
Ankur Gupta ◽  
Nishi Sharma ◽  
Akhilandeswari Prasad

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) affects 0.5-30% of individuals in any community and over 20 million people are estimated to suffer from this condition worldwide. COM often evolves in a continuum. Squamosal disease is more commonly found in poorly pneumatized bones, but whether the sclerosis is relevant to the etiology of the disease or is caused by it, has not been fully resolved. Our study aimed at comparing the mastoid pneumatization patterns obtained using X-ray mastoid and high-resolution computed tomography (HRCT) temporal bone. It was an interventional study.</p><p class="abstract"><strong>Methods:</strong> Sixty patients of unilateral squamosal COM, aged more than 8 years, underwent X-ray mastoid Schuller’s view and HRCT temporal bone, using Philips extended brilliance 48 slice CT.  </p><p class="abstract"><strong>Results:</strong> Upon analysis, in diseased and healthy ears, the coincidence of X-ray and HRCT findings was 63.33% and 80% respectively.</p><p class="abstract"><strong>Conclusions:</strong> HRCT temporal bone should be done in all cases of squamosal COM to know the extent of the disease, pneumatization patterns and the presence of anatomical variations.  </p>


Author(s):  
Gopinathan N. Pillai ◽  
Anjana Mary Reynolds ◽  
Melwin Tom

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) is characterized by ear discharge and hearing loss. There are two types of COM depending on the presence or absence of cholesteatoma. COM with cholesteatoma is termed as COM squamosal type and COM without cholesteatoma is termed COM mucosal type. COM squamosal type is associated with potential complications. If cholesteatoma is detected early, less invasive surgical methods can be used for hearing preservation and make ear safe from recurrent infections. A proper clinical examination can most often diagnose a cholesteatoma but require a high resolution computed tomography (HRCT) scan to assess the extent of the disease and potential complications. But most often the intra operative findings may not correlate with the HRCT findings. The aim of the study was to evaluate the clinical presentation of COM squamosal disease, preoperative HRCT and intra-operative findings and formulate a proper surgical intervention to avoid complications.  </p><p class="abstract"><strong>Methods:</strong> This is a comparative study of the pre-operative HRCT and intra-operative findings in COM squamosal type. In the present study of 35 patients with squamosal disease, the HRCT findings were compared with intra-operative findings.</p><p class="abstract"><strong>Results:</strong> The study showed a good correlation between pre-operative HRCT of temporal bone and intra operative finding. The findings are statistically significant (p&lt;0.001).</p><p class="abstract"><strong>Conclusions:</strong> The study shows a good correlation between pre-operative HRCT temporal bone and intra-operative findings.</p>


2009 ◽  
Vol 123 (11) ◽  
pp. 1288-1291 ◽  
Author(s):  
B Alva ◽  
K Chandra Prasad ◽  
S Chandra Prasad ◽  
S Pallavi

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.


2015 ◽  
Vol 42 (6) ◽  
pp. 492-495
Author(s):  
Kuniyuki Takahashi ◽  
Yutaka Yamamoto ◽  
Manabu Ogi ◽  
Shinsuke Ohshima ◽  
Yuka Morita ◽  
...  

2018 ◽  
Vol 23 (02) ◽  
pp. 184-190 ◽  
Author(s):  
Devira Zahara ◽  
Rima Diana Dewi ◽  
Askaroellah Aboet ◽  
Fikri Mirza Putranto ◽  
Netty Delvrita Lubis ◽  
...  

Introduction The cochlear anatomy varies in each individual, and that has an impact on decisions regarding the insertion of electrodes. The measurement of the cochlear size is the routine examination required to choose the proper cochlear implant (CI) electrodes. Objective To acquire normative data on the size of the cochlea (length, width, height, scala timpani [ST] height, cochlear duct length [CDL]) of CI candidates in Medan, Indonesia. Methods This descriptive study was conducted based on high-resolution computed tomography (HRCT) temporal bone data and on HRCT temporal data manipulated to reconstruct three-dimensional (3D) multiplanar images with OsiriX MD DICOM Viewer version 9.5.1 (Pixmeo SARL, Bernex, Geneva, Switzerland) viewer of 18 patients (36 ears) who were CI candidates in Medan, Indonesia, in order to determine cochlear length (A), cochlear width, cochlear height, ST height and CDL, calculated through a simple mathematical function. Results The average cochlear length (A) was 8.75 mm (standard deviation [SD] = 0.31 mm); the average cochlear width was 6.53 mm (SD = 0.35 mm); the average cochlear height was 3.26 mm (SD = 0.24 mm) and the average ST height at the basal cochlea was 1.00 mm (SD = 0.1 mm); and 0.71 mm (SD = 0.1 mm) at the half turn of cochlea. The average total CDL was 32.45 mm (SD = 1.31 mm; range: 30.01–34.83 mm). Conclusion The cochlear size varies in each individual; therefore, the temporal bone measurement of CI candidates using HRCT is essential: for the selection of suitable implant electrodes; to minimize cochlear damages at the insertion of the electrode arrays; and to maximize the hearing improvements.


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