1.Luc’s abscess: The zygomatic route of infection from cholesteatoma
Ramon Alfonso A. Dominguez ; Anne Margaux V. Artates
Philippine Journal of Otolaryngology Head and Neck Surgery 2022;37(1):52-54
Luc’s abscess is an uncommon complication of otitis media wherein a subperiosteal abscess develops into the temporalis muscle and follows the route of a pneumatized zygoma.1 In uncomplicated cases, surgical drainage and antibiotics are adequate management with mastoidectomy reserved for severe or complicated cases. We report a case of complicated Luc’s abscess presenting with many complications that required multiple surgical interventions.
Cholesteatoma
;
Zygoma
;
Mastoidectomy
;
Abscess
2.Delayed-onset unilateral facial paralysis after mastoidectomy: A case report
Elbert Digger Q. Baloco, MD ; Jose B. Orosa III, MD
Philippine Journal of Otolaryngology Head and Neck Surgery 2023;38(1):50-53
Objective:
To discuss the case of a 36-year-old man who presented with left unilateral facial paralysis 11 days after mastoidectomy.
Methods:
Design: Case Report
Setting: Tertiary Government Training Hospital
Patient: One
Results:
A 36-year-old man with recurrent left ear discharge of 30 years duration underwent left canal wall-down mastoidectomy and was discharged well after 3 days. On follow up after 8 more days, he was noted to have House Brackmann IV left facial paralysis. Following 5 days methylprednisolone, neurologic evaluation and physical therapy rehabilitation, facial paralysis improved in the ensuing weeks until House-Brackmann I was achieved at week 12.
Conclusion
Delayed-onset Facial Palsy (DFP) following tympanomastoid surgery may be approached conservatively, including steroids, acyclovir, and, if with a history of herpes or varicella infection, immunization can be given. Prognosis for DFP is good especially when the facial nerve is identified intraoperatively during otologic surgeries
facial nerve
;
mastoidectomy
3.Fatal otitic hydrocephalus due to sinus thrombosis: A case report
Claudette Gloria T. Plumo ; Emmanuel Tadeus S. Cruz
Philippine Journal of Otolaryngology Head and Neck Surgery 2022;37(1):38-42
Objective:
To report a case of chronic suppurative otitis media with complications of lateral sinus thrombosis and otitic hydrocephalus and to discuss its clinical manifestations, clinical course, ancillary procedures and management.
Methods:
Study Design: Case Report.
Setting: Tertiary Government Training Hospital.
Patient: One.
Results:
A 35-year-old man was admitted due to intermittent right otorrhea for 20 years and headache for a month. The Glasgow Coma Scale (GCS) score was 12, and mastoidectomy performed on the second hospital day showed cholesteatoma with erosion of the bony covering of the sigmoid sinus with scanty purulent discharge. The GCS improved to 15 few hours post- operatively, however, 24 hours post-operatively, GCS decreased from 15 to 10 and a CT scan showed dilatation of cerebral ventricles and lateral sinus thrombosis which persisted on subsequent imaging studies. His condition deteriorated irreversibly despite a ventriculostomy, and he eventually expired after 3 weeks in the ward.
Conclusion
Otitic hydrocephalus due to lateral sinus thrombosis is a serious complication of chronic suppurative otitis media seldom encountered nowadays. In this case, otitic hydrocephalus developed and progressed despite broad spectrum antibiotics, mastoidectomy and a ventricular shunt. This case report underscores the importance of early recognition of warning signs of intracranial complications to institute prompt management.
Lateral Sinus Thrombosis
;
Mastoidectomy
;
Ventriculostomy
4.Clinical manifestation and treatment of temporal bone tympanic plate fracture.
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2021;56(8):801-805
Objective: To elucidate the clinical manifestations of temporal bone tympanic plate fracture and the correlation between treatment time after injury and its prognosis, and to discuss the importance of early treatment of tympanic fracture. Methods: Retrospective analysis was carried out on the clinical data of 15 patients(17 ears)with temporal bone tympanic plate fracture from March 2006 to July 2019. The course of disease was less than 1 month (initial stage) in 7 cases (7 ears), 1 month to 6 months (middle stage) in 2 cases (3 ears), and 6 months or more (late stage) in 6 cases (7 ears). The symptoms, signs, CT findings, pure tone audiometry results, surgical methods and clinical efficacy of each group were summarized. Results: Most patients with temporal bone tympanic plate fracture were referred to otology department by maxillofacial surgery. Fracture occured indirectly with the chin or zygomatic region as the direct stress point. Thirteen of the 15 patients had mental region wounds or scars, and 14 patients had external acoustic canal bleeding immediately after injury. In the initial-stage group, hearing was mostly unchanged, while in the middle and late-stage groups, hearing loss was mainly caused by conduction factors. In the initial stage group, 6 cases/7 cases were cured by external acoustic canal packing; External acoustic canal stenosis or atresia occurred in 2 cases in the middle-stage group and were cured by external acoustic canal plasty. All the 6 patients in the late-stage group had external acoustic canal stenosis or atresia, among whom 5 patients with external acoustic canal cholesteatoma were cured by external acoustic canal plasty, and the other one patient with middle ear cholesteatoma was cured by modified radical mastoidectomy and tympanoplasty after external acoustic canal plasty for three times. Conclusions: Temporal bone tympanic plate fracture is a special type of temporal bone fracture. In the early stage of temporal bone tympanic fracture, bleeding of the external acoustic canal is the main symptom, and hearing is normal mostly. Advanced conductive deafness may result from external acoustic canal stenosis and/or cholesteatoma formation later. Bleeding of the external acoustic canal and irregular bulge of the anterior wall of the external acoustic canal with mental region wound are important signs for early diagnosis of temporal bone fracture. Temporal bone tympanic fracture should be paid attention to, early detection and timely treatment can avoid external acoustic canal stenosis and atresia.
Cholesteatoma, Middle Ear/surgery*
;
Ear Canal
;
Humans
;
Mastoid
;
Mastoidectomy
;
Retrospective Studies
;
Temporal Bone/diagnostic imaging*
;
Treatment Outcome
;
Tympanoplasty
5.Intact Canal Wall Mastoidectomy Combined with Balloon Dilation Eustachian Tuboplasty in the Treatment of Middle Ear Cholesterol Granuloma.
Yong-Kang OU ; ; Xue-Yuan ZHANG ; ; Yao-Dong XU ; ; Hao XIONG ; ; Mao-Jin LIANG ;
Chinese Medical Journal 2018;131(6):741-742
Adult
;
Cholesterol
;
Dilatation
;
Ear Canal
;
Ear Neoplasms
;
surgery
;
Ear, Middle
;
pathology
;
Eustachian Tube
;
Female
;
Granuloma
;
surgery
;
Humans
;
Male
;
Mastoidectomy
;
Middle Aged
;
Treatment Outcome