Devaraja K, Nayak Dipak Ranjan
Department of Otorhinolaryngology and Head and Neck Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Udupi, Karnataka, 576104, India.
J Otol. 2020 Sep;15(3):112-116. doi: 10.1016/j.joto.2020.01.004. Epub 2020 Jan 25.
Inflammation of a part or whole of the temporal bone and surrounding soft tissue is termed as malignant otitis externa, which typically spreads to skull base to involve cranial nerves VII. Rarely can it also effect one or more of cranial nerves IX, X, XI, and XII. We present a case of malignant otitis externa which presented with symptomatic palsy of IX and XII nerves sparing the VII cranial nerve. The patient though later on had internal jugular vein thrombosis, which we presume is due to the involvement of the parapharyngeal space that prompted us to reconsider the diagnosis, and later on, to aggravate the therapy. With proper blood sugar control and appropriate long term antibiotics, not only that the patient is disease free at one year follow up, but the cranial nerve deficits also recovered. Apart from sharing the clinical and management details of this patient, we have reviewed the relevant literature in the discussion, which has shed some light onto some of the interesting facts about this condition and its prognosis.
颞骨部分或全部以及周围软组织的炎症被称为恶性外耳道炎，其通常会蔓延至颅底，累及面神经 VII。极少数情况下，它也会影响舌咽神经（IX）、迷走神经（X）、副神经（XI）和舌下神经（XII）中的一条或多条。我们报告一例恶性外耳道炎病例，该病例表现为舌咽神经和舌下神经的症状性麻痹，而面神经 VII 未受累。尽管该患者后来出现了颈内静脉血栓形成，我们推测这是由于咽旁间隙受累所致，这促使我们重新考虑诊断，并随后加强了治疗。通过适当的血糖控制和合适的长期抗生素治疗，不仅患者在一年的随访中无疾病复发，而且颅神经功能缺损也得到了恢复。除了分享该患者的临床和治疗细节外，我们在讨论中还回顾了相关文献，这些文献揭示了有关这种疾病及其预后的一些有趣事实。
