Rato Catarina, Lopes Gustavo, Duarte Delfim, Oliveira Nuno
Department of Otorhinolaryngology & Head and Neck Surgery, Hospital Pedro Hispano, Matosinhos, Portugal.
Turk Arch Otorhinolaryngol. 2021 Mar;59(1):80-83. doi: 10.4274/tao.2020.6058. Epub 2021 Mar 26.
Foreign bodies in the external ear are very common. The same cannot be said about foreign bodies in the Eustachian tube (ET). We report the case of a 63-year-old woman with a history of painless left side otorrhea and hearing loss. She reported a left ear surgery when she was 30-year-old but she did not know the diagnosis that was made at that time neither the kind of surgery performed. Otoscopic examination revealed an inferior perforation of the eardrum. Audiologic evaluation demonstrated a unilateral, moderate-severe mixed hearing loss. Computed tomography scan showed, in left ear, a soft tissue density filling the middle ear cavity and a foreign body in ET. The patient underwent middle ear exploration which required endoscopic assistance to visualize and remove the foreign body. It appeared to be a stapes prothesis of Robinson type. The displacement of a stapes prosthesis to the ET has not been reported in the literature. Surgeries in this region are challenging. This case highlights the importance of the integration of endoscopy into otologic surgery.
外耳道异物非常常见。咽鼓管异物的情况则并非如此。我们报告一例63岁女性病例,她有左侧无痛性耳漏和听力损失病史。她报告30岁时做过左耳手术,但她既不知道当时的诊断结果,也不清楚所做的手术类型。耳镜检查发现鼓膜下方穿孔。听力学评估显示为单侧中度至重度混合性听力损失。计算机断层扫描显示,左耳中耳腔内有软组织密度影,咽鼓管内有异物。患者接受了中耳探查,术中需要内镜辅助以观察和取出异物。异物似乎是罗宾逊型人工镫骨。人工镫骨移位至咽鼓管的情况在文献中未见报道。该区域的手术具有挑战性。本病例突出了内镜在耳科手术中应用的重要性。