scholarly journals Double Trouble of Double Fistulae

Biomedicine ◽  
2021 ◽  
Vol 41 (1) ◽  
pp. 163-165
Author(s):  
Deviprasad Dosemane ◽  
Meera Niranjan Khadilkar ◽  
Shreyanshi Gupta ◽  
Pooja Nambiar ◽  
Ria Mukherjee

The complications of attico-antral type of Chronic Suppurative Otitis Media (CSOM) are severe due to underlying bone erosion. We describe a case of a 40-year-old lady with attico-antral CSOM and mastoiditis with a postauricular fistula, who underwent modified radical mastoidectomy with excision of the postauricular cutaneous mastoid fistula. Interestingly, another fistula over the dome of lateral semicircular canal was noted intraoperatively.Few reports of occurrence of postauricular mastoid fistula with a labyrinthine fistula have been documented.

Author(s):  
Ameya Bihani ◽  
Jyoti P. Dabholkar

<p class="abstract"><span lang="EN-US">Bezold’s abscess is a very rare complication of unsafe chronic suppurative otitis media. The diagnosis of Bezold’s abscess is clinched by the presence of inflammation which is tracking down the anterior belly of digastrics and sternocleidomastoid. Surgery constituting incision and drainage of abscess with canal wall modified radical mastoidectomy is treatment of choice. We hereby present a case of 42 year male presenting with parapharyngeal abscess (Bezold’s abscess) which was secondary to unsafe chronic suppurative otitis media.</span></p>


2021 ◽  
Vol 15 (6) ◽  
pp. 1426-1428
Author(s):  
W. Javaid ◽  
A. Rashid ◽  
M. U. K. Amin ◽  
T. Khan ◽  
M. Fatima

Background: Cholesteotoma is a benign but destructive lesion leading to ossicular necrosis. Objective: To see the frequency of incus bone erosion on mastoid exploration in chronic suppurative otitis media with middle ear cholesteotoma. Study Design: Cross-sectional descriptive study. Setting: This study was carried out in the Department of ENT Unit-2, Sir Ganga Ram Hospital, Lahore. Duration of Study: Fifteen months months (10th April, 2019 to 9th July, 2020) Sample technique: Non- probability purposive sampling Methods: One hundred and twenty patients were admitted through outpatient department of ENT Unit-2, Sir Ganga Ram Hospital Lahore. Patients were included after fulfilling the inclusion criteria and information was collected on a prescribed proforma. Finally during surgery under general anesthesia, the operative findings were noted to know the incus bone erosion after middle ear cholesteatoma formation in chronic suppurative otitis media. Results: A total number of one hundred and twenty patients of chronic suppurative otitis media with middle ear cholesteatoma were included. Out of which 80 (66.7%) were males and 40 (33.3%) were females(Table 1).The patients shown in table 2 were divided in six age groups (Table 2).Table 3 shows that the procedure of mastoidectomy was performed in 112 patients (93.3%) and modified radial mastoidectomy was performed in 8 patients (6.7%).Incus bone erosion in chronic suppurative otitis media with middle ear cholesteatoma in 102 patients (85%) and 18 patients (15%) have no incus bone erosion (Table 4). Conclusion: Ear discharge was the most common presenting characteristic of chronic suppurative otitis media with cholesteatoma. The majority of the cases had ossicular erosion, with the incus being the most common site of involvement. Males are more likely than females to develop cholesteatoma. Keywords: erosion of incus bone, Mastoid exploration, Chronic suppurative otitis media, Cholesteatoma


1988 ◽  
Vol 97 (4) ◽  
pp. 373-375 ◽  
Author(s):  
A. Olu Ibekwe ◽  
Benjamin C. C. Okoye

In Europe and America, acute mastoiditis usually appears as a complication of acute otitis media, and some patients develop subperiosteal mastoid abscesses. In Nigeria, however, most subperiosteal mastoid abscesses develop from chronic otitis media with cholesteatoma. Of the 16 patients with subperiosteal mastoid abscesses discussed, 11 (69 %) had cholesteatoma and only five (31 %) had granulation tissue in the mastoid cavity. The ideal treatment for these cases is modified radical mastoidectomy. Radiographic investigation of the mastoid can be useful in the diagnosis of cholesteatoma in the presence of a subperiosteal mastoid abscess.


1991 ◽  
Vol 105 (12) ◽  
pp. 990-994 ◽  
Author(s):  
B. J. O'Reilly ◽  
E. B. Chevretton ◽  
I. Wylie ◽  
C. Thakkar ◽  
P. Butler ◽  
...  

AbstractHigh definition CT has been advocated for the evaluation of chronic suppurative otitis media (CSOM) either generally or in selected cases. It is said to be capable of producing the fine detail needed to detect lateral canal fistulae, exposed dura and facial canal dehiscences, and to demonstrate the ossicular chain. At present there is no agreement on either the indications for CT scanning in CSOM or the most appropriate scanning plane. To determine the value of high definition CT in CSOM and to decide a unit policy for its application, 36 cases of CSOM underwent pre-operative CT scanning and their scans were compared with the operative findings.Our results show CT to be highly sensitive to the presence of soft tissue disease and bone erosion, moderately sensitive to the presence of lateral canal fistulae but less sensitive to the presence of small areas of exposed dura, ossicular continuity and facial canal dehiscence. Axial scans were better able to demonstrate the lateral canal but otherwise coronal scans were superior; ideally patients should be scanned in both planes. The principle value of CT in CSOM is its ability to demonstrate disease which is not clinically apparent.


2003 ◽  
Vol 117 (5) ◽  
pp. 353-357 ◽  
Author(s):  
D. S. Grewal ◽  
Bachi T. Hathiram ◽  
Ashwani Dwivedi ◽  
Lovneesh Kumar ◽  
Kaushal Sheth ◽  
...  

A labyrinthine fistula is a frequent complication of long-standing unsafe chronic suppurative otitis media. It is characterized by a slowly progressive erosion of the bony labyrinth. In this paper we present our observations regarding the diagnosis and management in 50 patients with unsafe chronic suppurative otitis media with labyrinthine fistula.


e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 351
Author(s):  
A. Fitrah Muhibbah ◽  
Mirna Muis ◽  
Nurlaily Idris ◽  
Andi A. Zainuddin ◽  
Masyita Gaffar ◽  
...  

Abstract: This study was aimed to determine the accuracy of preoperative temporal bone CT-scan ini assessing cholesteatoma in chronic suppurative otitis media (CSOM) patients. This was a diagnostic test study conducted by comparing the findings of the preoperative temporal bone CT-scan with the intraoperative findings of 54 CSOM patients who had a temporal bone CT-scan followed by surgery at the Hasanuddin University Hospital and the Jaury Academic Hospital. Assessment of cholesteatoma on a preoperative temporal bone CT-scan was performed when soft tissue density was found in the middle ear accompanied by bone erosion. In addition, an assessment was also carried out for the presence of ossicular, scutum, tympanic tegmen, facial nerve canal and mastoid tegmen erosions. The results indicated that the accuracy of preoperative temporal bone CT-scan in assessing cholesteatoma in CSOM patients was 87.04% with a sensitivity of 85%, specificity of 88.23%, a positive predictive value of 80.95%, and a negative predictive value of 90.91%. The sensitivity of the preoperative temporal bone CT-scan in assessing the highest erosion of cholesteatoma in the erosion of the scutum and tympanic tegmen (100%) with the specificity and accuracy of the preoperative temporal bone CT scan of the in assessing erosions in cholesteatoma highest on mastoid tegman erosion  (100% and 96.29%). In conclusion, preoperative CT scan of temporal bone has high accuracy, sensitivity, and specifity values in assessing cholesteatoma and erosions of surrounding structures.Keywords: cholesteatoma, chronic suppurative otitis media (CSOM), temporal bone CT-Scan  Abstrak: Penelitian ini bertujuan untuk mengetahui akurasi gambaran CT-scan tulang temporal preoperatif dalam menilai kolesteatoma pada penderita otitis media supuratif kronis (OMSK). Jenis penelitian ialah uji diagnostik yang membandingkan temuan pada CT scan tulang temporal preoperatif dengan hasil temuan intraoperatif pada 54 penderita OMSK yang menjalani pemeriksaan CT scan tulang temporal dilanjutkan dengan tindakan operasi di Rumah Sakit Universitas Hasanuddin dan Rumah Sakit Akademis Jaury. Penilaian kolesteatoma pada CT Scan tulang temporal preoperatif ketika ditemukan densitas jaringan lunak di telinga tengah yang disertai dengan erosi tulang. Selain itu, dilakukan penilaian adanya erosi osikula, skutum, tegmen timpani, kanalis nervus fasialis, dan tegmen mastoid. Hasil penelitian mendapatkan akurasi CT scan tulang temporal preoperatif dalam menilai kolesteatoma pada penderita OMSK sebesar 87,04% dengan sensitivitas 85%, spesifisitas 88,23%, nilai prediksi positif 80,95%, dan nilai prediksi negatif 90,91%. Sensitivitas CT scan tulang temporal preoperatif dalam menilai erosi pada kolesteatoma tertinggi pada erosi skutum dan tegmen timpani (100%) dengan spesifisitas dan akurasi CT scan tulang temporal preoperatif dalam menilai erosi pada kolesteatoma tertinggi pada erosi tegmen mastoid (100% dan 96.29%). Simpulan penelitian ini ialah CT scan tulang temporal preoperatif memiliki nilai akurasi, sensitivitas, serta spesifisitas yang cukup tinggi dalam menilai kolesteatoma serta erosi pada struktur di sekitarnya.Kata kunci: kolesteatoma, otitis media supuratif kronis (OMSK), CT scan tulang temporal


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