Humans ; Osteonecrosis ; complications ; diagnosis ; Otitis Externa ; complications ; diagnosis ; Temporomandibular Joint ; pathology

OBJECTIVE: To assess the diagnosis and therapeutic effects for fungal otitis externa by clinical symptoms, endoscopic findings, and fungus culture of the ear discharge. METHOD: Sixty outpatients diagnosed with otitis externa were enrolled in the study. All patients were treated with a thorough debridement of the ear and one antifungal medication regimens (compound resorcinol solution) in case of a positive fungus culture. One subgroup of patients treated with daub glycerol during 2 weeks of follow-up. RESULT: Positive cultures were found in 42 cases. The efficacy was observed in all patients even in those who received only ear endoscopy. CONCLUSION Fungal otitis externa could be easily diagnosed by ear endoscopy. A thorough debridement of the ear and utility of compound resorcinol solution is an easy and effective approach for treatment of fungal otitis externa.
Antifungal Agents ; therapeutic use ; Debridement ; Fungi ; Glycerol ; Humans ; Otitis Externa ; diagnosis ; microbiology ; Otomycosis ; diagnosis ; Outpatients

Skull base osteomyelitis is a rare, refractory, and potentially fatal disease primarily caused by otogenic and sino rhinogenic infections. At times, it can mimic neoplasia complicating the diagnosis. With the use of antibiotics, advancements in diagnostic methods, and skull base surgical techniques, the mortality rate has significantly improved. However, the successful diagnosis and treatment of the disease is still challenging due to delayed diagnosis, lengthy treatment course, a tendency for relapse and lack of guidelines. Therefore, this article aims to review the progress in the diagnosis and treatment of skull base osteomyelitis.
Humans ; Otitis Externa/diagnosis* ; Skull Base ; Osteomyelitis/complications* ; Anti-Bacterial Agents/therapeutic use* ; Diagnosis, Differential

Adult ; Aged ; Diagnostic Errors ; Female ; Humans ; Male ; Middle Aged ; Necrosis ; Otitis Externa ; diagnosis ; pathology

A malignant tumor of the external auditory canal (EAC) is a rare tumor, with a prevalence of between 1 and 6 people per 1 million population. Common symptoms of the EAC cancer include otorrhea, hearing loss, otalgia, or tinnitus, which are similar to symptoms of otitis media or otitis externa. Therefore, diagnosis may be delayed due to lack of EAC cancer-specific symptoms and the prognosis is also relatively poor despite intensive treatment. The most malignant tumor of the EAC is squamous cell carcinoma (SCC), which usully invades the ear unilaterally. SCC of bilateral EAC is extremely rare. We report here a rare case of bilateral EAC SCC. In this case, unilateral EAC SCC was treated via stereotactic radiosurgery and contralateral EAC SCC developed subsequently. This case implicates that radiosurgery can be a treatment option for EAC SCC but it may have carcinogenic effect. This case also shows that the ear should be examined bilaterally even when unilateral EAC cancer is encountered.
Carcinoma, Squamous Cell* ; Diagnosis ; Ear ; Ear Canal* ; Earache ; Epithelial Cells* ; Hearing Loss ; Otitis Externa ; Otitis Media ; Prevalence ; Prognosis ; Radiosurgery ; Tinnitus

Malignancy of the external auditory canal (EAC) is a rare tumor. Among the malignancies of EAC, squamous cell carcinoma (SCC) is the most common pathologic type. The causes of SCC of EAC may be exposure to ultraviolet rays, cholesteatoma, chronic otitis externa, and rarely radiotherapy. SCC of EAC has the diverse and non-specific clinical features including mass of tissue, otorrhea, otalgia, tinnitus, and facial palsy which make it difficult to distinguish between SCC and benign tumor. Recently, we experienced a case of SCC of EAC occurred in the left external auditory canal after radiotherapy for Kimura's disease, which was misdiagnosed as keratoacanthoma at first. The findings of this case suggest that when it is difficult to distinguish SCC from benign tumor of EAC, the excisional biopsy including enough resected margin and base of tumor is needed for an exact diagnosis.
Biopsy ; Carcinoma, Squamous Cell* ; Cholesteatoma ; Diagnosis ; Ear Canal* ; Earache ; Epithelial Cells* ; Facial Paralysis ; Keratoacanthoma* ; Otitis Externa ; Radiotherapy* ; Tinnitus ; Ultraviolet Rays

Kostmann's disease is a rare hematologic disease entity which is characterized by persistent neutropenia and recurrent bacterial infections since early in infancy. The authors experienced a 2-month-old female infant with disseminated bacterial skin infection since 3 weeks of age and persistent neutropenia. Diagnosis was made by neutropenia in the peripheral blood, maturation arrest of myeloid hemopoiesis at myelocyte stage in the finding of bone marrow aspiration and improving response of neutropenia with G-CSF administration. She had experienced 4 episodes of sepsis and one episode of acute otitis externa during follow-up until 14 months of age.
Bacterial Infections ; Bone Marrow ; Bone Marrow Transplantation ; Diagnosis ; Female ; Follow-Up Studies ; Granulocyte Colony-Stimulating Factor ; Granulocyte Precursor Cells ; Hematologic Diseases ; Humans ; Infant ; Neutropenia ; Otitis Externa ; Sepsis ; Skin

otitis externa, but some of atypical osteomyelitis have been reported. It most commonly presents old diabetic patients, and have high morbidity and mortality rate if diagnosis and treatment are delayed. However with respect to pain or dysfunction, it appeared similar to the initial symptoms of temporomandibular joint disorder. So frequently, definitive diagnosis is tend to delayed. We have clinical experience that a patient who presented with symptom similar to temporomandibular disorder, and differential diagnosised by skull base osteomyelitis. We will report this case with literature review.]]>
Bone Marrow ; Diagnosis, Differential ; Ear Canal ; Humans ; Occipital Bone ; Osteomyelitis ; Otitis Externa ; Rare Diseases ; Skull ; Skull Base ; Sphenoid Bone ; Temporal Bone ; Temporomandibular Joint ; Temporomandibular Joint Disorders

BACKGROUND AND OBJECTIVES: Skull base osteomyelitis (SBO) typically evolves as a complication of malignant otitis externa (MOE) in diabetic patients and involves the temporal bone. Central SBO (CSBO), which mainly involves the sphenoid or occipital bones, has clinicaland radiological characteristics similar to those of SBO but without coexisting MOE. We investigated a group of patients with CSBO and studied the clinical course of CSBO. SUBJECTS AND METHOD: Medical records of patients who were diagnosed with CSBO were retrospectively analyzed from 1999 to 2014. RESULTS: Ten patients (mean age; 60.5 years) were identified. There were five males and five females. All patients suffered from headache, and six patients had cranial nerve palsy including oculomotor (20%), abducens (10%), vestibulocochlear (10%), glossopharyngeal (20%), vagus (30%) and hypoglossal (10%) nerve. Patients had underlying diseases including diabetes mellitus (40%), immunosuppression status after liver transplantation (10%) and cardiovascular disease (40%). Four patients received endoscopic biopsy and debridement for diagnostic and curative intent. Patients were treated with intravenous antibiotics for 5.1 weeks in average and oral antibiotics for 17 weeks. Mean follow-up period was 12.4 months and the mortality rate was zero. 40% of patients had residual neurologic deficit. The earliest sign of improving CSBO was headache (mean; 3.1 weeks) and the erythrocyte sedimentation rate was the latest improving sign (mean; 4 months). CONCLUSION: CSBO was diagnostic and therapeutic challenge to the clinicians. The timely diagnosis and long-term antibiotics therapy could avoid a mortality case and minimize the permanent neurologic deficit.
Anti-Bacterial Agents ; Biopsy ; Blood Sedimentation ; Cardiovascular Diseases ; Cranial Nerve Diseases ; Debridement ; Diabetes Mellitus ; Diagnosis ; Female ; Follow-Up Studies ; Headache ; Humans ; Immunosuppression ; Liver Transplantation ; Male ; Medical Records ; Mortality ; Neurologic Manifestations ; Occipital Bone ; Osteomyelitis* ; Otitis Externa ; Retrospective Studies ; Skull Base* ; Skull* ; Temporal Bone