Tornari Chrysostomos, Pal Surojit, Lingam Ravi Kumar, Kalan Ali
Department of ENT, Northwick Park Hospital, London, UK.
Department of Radiology, Northwick Park Hospital, London, UK.
BMJ Case Rep. 2015 Mar 20;2015:bcr2014207550. doi: 10.1136/bcr-2014-207550.
A man in his early 30s presented with right-sided preauricular swelling and facial oedema. He had a history of acid injury to his right ear as a child resulting in pinna deformity and subsequent blind sac closure of the external auditory canal. Imaging showed abnormal ear anatomy and abnormal density of the right parotid gland. Antibiotic therapy prevented progression but did not resolve the symptoms. Therefore, the infected area was surgically drained. This showed an underlying cholesteatoma, a benign but locally destructive condition where keratinising squamous epithelium grows in the middle ear and mastoid. The infected region was drained and the cholesteatoma was excised. This led to full resolution of the infection. The patient is awaiting a follow-up diffusion-weighted MRI. This case was unusual as the disease had extended beyond the ear and we therefore wish to alert clinicians to cholesteatoma as a possible cause of facial swelling.
一名30岁出头的男性出现右侧耳前肿胀和面部水肿。他童年时有右耳酸烧伤史，导致耳廓畸形，随后外耳道盲袋闭合。影像学检查显示耳部解剖结构异常及右侧腮腺密度异常。抗生素治疗阻止了病情进展，但症状未缓解。因此，对感染区域进行了手术引流。结果发现了潜在的胆脂瘤，这是一种良性但具有局部破坏性的疾病，其中角化鳞状上皮在中耳和乳突中生长。对感染区域进行了引流，并切除了胆脂瘤。这使得感染完全消退。患者正在等待后续的弥散加权磁共振成像检查。该病例不同寻常，因为疾病已蔓延至耳部以外，因此我们希望提醒临床医生，胆脂瘤可能是面部肿胀的一个原因。
