Post on 14-Apr-2015
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Dr. Rishank Kishore Resident
ENT & Head-Neck Surgery
27/Male
Foul smelling lt. ear discharge for 2 years
Deviation of angle of mouth rt. side for 2 days
History of present illness:• Discharge was blood stained, foul smelling,
continuous, purulent in nature, scanty in amount without any associated URTI.
• Deviation of angle of mouth rt. side was sudden in onset and progressive.
• Patient was under treatment of a private practitioner, details of which are not available.
Personal History : Non alcoholic Non smoker
Past HistoryFamily History Not ContributoryDrug Allergy
Average built & nourished Vitals – WNL
Systemic Examination: normal
All blood & urine routine investigations were normal
Left unsafe chronic suppurative otitis media with facial palsy as a resultant complication.
The treatment for this condition is immediate mastoid exploration with decompression of the facial nerve.
MRM FACIAL NERVE DECOMPRESSION
It was found during surgery that vertical segment of facial nerve was compressed which is very uncommon.
Patient was operated within 2 days of presentation. So he started recovering soon after surgery, and recovered completely within one month.
Extra cranial: Mastoiditis Facial palsy Labyrinthitis
Intra cranial: Meningitis Extradural abscess Subdural abscess Lateral sinus
thrombophlebitis Temporal lobe
abscess Cerebellar abscess Otitic
hydrocephalus
With the advent of newer antibiotics and high resolution imaging techniques the incidence of complications of Chronic Suppurative Otitis media has become very rare.
It only occurs when there is some level of ignorance either at the level of the patient or the treating doctor.