al-Shihabi B A
Royal National Throat, Nose and Ear Hospital, London.
J Laryngol Otol. 1992 Oct;106(10):908-10. doi: 10.1017/s0022215100121255.
A 69-year-old man presented with a three-month history of otalgia and tenderness of the right ear and a one-week history of a painful right parotid swelling. Examination revealed granulation tissue in the right ear canal with normal looking tympanic membranes and a parotid abscess. Repeated biopsies from the ear canal and parotid showed non-specific inflammation. Repeated cultures from both areas grew Ps. aeruginosa. The patient's condition improved following three weeks of intensive treatment for malignant otitis externa only to relapse five weeks after the end of treatment. He received a second course, only to improve temporarily. He developed a right facial nerve palsy five weeks after he was first seen, followed four months later by palsies of all cranial nerves except the olfactory, before dying, seven months after his first appointment. The radiological, histological and post-mortem findings are discussed.
一名69岁男性，有3个月的右耳耳痛及压痛病史，以及1周的右侧腮腺肿痛病史。检查发现右侧耳道有肉芽组织，鼓膜外观正常，并有腮腺脓肿。耳道和腮腺的多次活检显示为非特异性炎症。两个部位的多次培养均培养出铜绿假单胞菌。该患者在接受了3周的恶性外耳道炎强化治疗后病情好转，但在治疗结束5周后复发。他接受了第二个疗程的治疗，只是暂时有所改善。首次就诊5周后，他出现了右侧面神经麻痹，4个月后，除嗅觉神经外的所有颅神经均出现麻痹，首次就诊7个月后死亡。本文讨论了影像学、组织学及尸检结果。
