Parelkar Kartik, Shere Devika, Wallic Ankur, Dave Varun, Rao Karthik
Department of Otorhinolaryngology , Grant Government Medical College and Sir J.J Hospitals, Mumbai, India.
Department of Otorhinolaryngology , Durgabai Deshmukh Hospital, Hyderabad, India.
Iran J Otorhinolaryngol. 2019 Mar;31(103):123-126.
Foreign bodies in the external auditory canal are fairly common, and tend to be seeds, toys, or insects. However, foreign bodies in the middle ear are rarer and are generally accidental or iatrogenic. Although there are numerous reports regarding fascinating foreign bodies in the ear, the same cannot be said about foreign bodies in the Eustachian tube (ET).
A 20-year-old male patient presented with right-sided active squamosal chronic otitis media (COM) persisting for 10 years. An incidental finding of a hyperintense foreign body (FB) located near the isthmus of the right ET was reported on high-resolution computed tomography (HRCT) of the temporal bones. The FB was bony (eroded incus), which was impacted near the isthmus of the ET and was extremely difficult to remove. A natural FB such as an eroded ossicle in the ET which aggravated the adhesive otitis and caused active squamosal COM has not been reported in the literature.
We have reported this case not only for its rarity but also to make readers aware of such incidental findings which can be found only by imaging, and to suggest how they can be tackled with current equipment and technology.
外耳道异物相当常见,多为种子、玩具或昆虫。然而,中耳异物较为罕见,通常是意外或医源性的。尽管有许多关于耳部迷人异物的报道,但关于咽鼓管(ET)异物的报道却很少。
一名20岁男性患者,右侧活动性鳞状慢性中耳炎(COM)病史10年。颞骨高分辨率计算机断层扫描(HRCT)报告意外发现右侧咽鼓管峡部附近有一高强度异物(FB)。该异物为骨质(侵蚀的砧骨),嵌顿于咽鼓管峡部附近,极难取出。文献中尚未报道过自然异物如咽鼓管内侵蚀的听小骨加重粘连性中耳炎并导致活动性鳞状中耳炎的情况。
我们报告此病例不仅因其罕见,还为使读者了解此类仅通过影像学才能发现的意外发现,并建议如何利用现有设备和技术进行处理。