Vishnu Swaroop Reddy N, Natti Raja Sekharam, Radha T, Sharma Manoj, Chintham Murali
Department of ENT, Care Hospitals, Banjara Hills, Hyderabad, Telangana 500034 India.
Indian J Otolaryngol Head Neck Surg. 2019 Mar;71(1):140-143. doi: 10.1007/s12070-018-1428-y. Epub 2018 Jun 20.
To demonstrate the affection of skull base by mucormycosis in an immunocompetent individual. Mucormycosis is an opportunistic infection principally seen in immunocompromised individuals, but recently being increasingly recognized in otherwise healthy individuals. Skull base involvement secondary to otogenic nidus, mimicking otitis media was rarely reported. A 34 year-old male, an otherwise healthy patient presented with facial nerve palsy followed by trismus, neck swelling and neck stiffness. Radical mastoidectomy with tympanoplasty and Facial nerve decompression along with Endoscopic guided debridement of sinuses and pterygopalatine fossa followed by medical treatment for 14 weeks. Facial nerve functioning, dry ear canal and relief from other symptoms. Surgical debridement and post op Anti fungal treatment improved the facial nerve function to House brackmann grade-II and also provided relief from trismus and stiffness and improved the overall general condition of the patient. Mucor is a saprophytic organism, which can cause extensive progression, regardless of the immune status. To the best of our knowledge, this is one of the very few rare cases that have been reported in the context of skull base mucormycosis in immunocompetent individuals. Surgical debridement followed by anti fungal therapy continues to remain the mainstay of treatment.
目的是展示毛霉菌病对免疫功能正常个体颅底的影响。毛霉菌病是一种主要见于免疫功能低下个体的机会性感染，但最近在其他方面健康的个体中也越来越多地被认识到。继发于耳源性病灶、酷似中耳炎的颅底受累情况鲜有报道。一名34岁男性，原本健康，出现面神经麻痹，随后出现牙关紧闭、颈部肿胀和颈部僵硬。行根治性乳突切除术加鼓室成形术及面神经减压术，同时在内镜引导下清理鼻窦和翼腭窝，随后进行14周的药物治疗。面神经功能恢复、耳道干燥且其他症状缓解。手术清创和术后抗真菌治疗使面神经功能改善至House-Brackmann二级，还缓解了牙关紧闭和僵硬症状，改善了患者的整体一般状况。毛霉菌是一种腐生菌，无论免疫状态如何，均可导致广泛进展。据我们所知，这是免疫功能正常个体颅底毛霉菌病中报道的极少数罕见病例之一。手术清创后进行抗真菌治疗仍然是主要的治疗方法。
