Malignant External Otitis With Multiple Cranial Nerve Palsies: The Use Of Hyperbaric Oxygen

10.5580/22a7 ◽  
2005 ◽  
Vol 4 (1) ◽  
IDCases ◽  
2020 ◽  
Vol 22 ◽  
pp. e00945
Author(s):  
Rodrigo Queiroz Silveira ◽  
Viviane Tavares Carvalho ◽  
Haline Novais Cavalcanti ◽  
Fabiana Carraro Eduardo Rodrigues ◽  
Caroline Bittar Braune ◽  
...  

2019 ◽  
Vol 25 (5) ◽  
pp. 362-364 ◽  
Author(s):  
Hiroshi Komamura ◽  
Takaaki Nakamura ◽  
Junpei Kobayashi ◽  
Ryuhei Harada ◽  
Kaoru Endo ◽  
...  

1977 ◽  
Vol 86 (4) ◽  
pp. 417-428 ◽  
Author(s):  
James R. Chandler

Malignant external otitis is an infection which begins in the external auditory canal. It is uniformly caused by the Gram negative Pseudomonas aeruginosa organism and mainly affects elderly diabetics. It spreads to the soft tissues beneath the temporal bone and, if not properly treated leads to facial nerve palsy, mastoiditis, sepsis, osteomyelitis of the base of the skull, sigmoid sinus thrombosis, multiple cranial nerve palsies and death. Experience with 72 patients in varying stages of the disease is summarized. Stressed are the diagnostic criteria of nonresponsiveness to the usual methods of treatment, continued suppuration, and the continuing reformation of granulation tissue in the floor of the external auditory canal. Medical treatment is recommended with hospitalization and intravenous carbenicillin and gentamicin. Minor surgical debridement is helpful. All patients should be treated medically for as long as improvement continues, reserving surgical intervention only in the event a plateau is reached or symptoms and signs become worse under treatment. With or without a major surgical procedure, it is imperative to continue treatment for at least seven days after apparent cure in order to avoid recurrent disease possibly at a site distant from the canal.


2016 ◽  
Vol 15 (1) ◽  
pp. 40-42
Author(s):  
Atul Kumar Singh

Some form of ophthalmic injury is seen in the majority of lightening victims. These may be anterior segment involvement, mostly the cornea. Other lesion on the anterior segment include uveitis, hyphaema, cataract and dislocated lens. Posterior segment lesion include vitreous haemorrhage, retinal oedema, retinal haemorrhage, retinal detachment, cystoids macular oedema, chorioretinalrupture, maculopathy, CRVO and CRAO. Neuro-ophthalmic lesion include loss of pupillaryreflex, anisocoria, horner syndrome, multiple cranial nerve palsies and nystagmus.


2020 ◽  
Vol 50 (1) ◽  
pp. 77
Author(s):  
Ratna Dwi Restuti

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.


Author(s):  
Uzma Nasim Siddiqui

Plasma cell myeloma rarely presents with neurological symptoms, and if this happens then cause is usually plasmacytoma. This is a very rare case to be presented as multiple cranial nerve palsies, unusual presentation of plasma cell myeloma without involvement of organic brain lesion in literature to date. A 70 years old gentleman having ESRD, was received with diplopia, deviation of angle of mouth, on and off chest pain. Investigations ruled out stroke, cardiac event, autoimmune process or any other possible cause of cranial nerve palsies. Diagnosis of multiple myeloma was confirmed by immune electrophoresis which showed monoclonal gammopathy, punched out lytic lesions were found on skeletal scurvy and later confirmation was done by bone marrow biopsy for the presence of plasma cell myeloma. Key words: plasma cell myeloma, cranial nerve palsies


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