Hostname: page-component-8448b6f56d-c47g7 Total loading time: 0 Render date: 2024-04-25T06:34:44.573Z Has data issue: false hasContentIssue false

Aspergilloma of the middle ear mimicking necrotising otitis externa: case report

Published online by Cambridge University Press:  11 June 2010

P Rainsbury*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Derriford Hospital, Plymouth, UK
A Mitchell-Innes
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Derriford Hospital, Plymouth, UK
H Wilson
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Derriford Hospital, Plymouth, UK
M Prior
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Derriford Hospital, Plymouth, UK
*
Address for correspondence: Mr Paul Rainsbury, Derriford Hospital, Plymouth, Devon PL6 8DL, UK. E-mail: paul.rainsbury@nhs.net

Abstract

Objective:

We report a case of a patient who presented with otalgia and facial nerve palsy secondary to an aspergilloma of the middle ear.

Case report:

A 72-year-old, diabetic man presented to the ENT department with a history of worsening right-sided otalgia, aural discharge and hearing loss, associated with a right-sided facial weakness. This was assumed to be secondary to malignant otitis externa, and treatment was commenced. Imaging showed soft tissue within the middle ear and no bony erosion. Surgical exploration and biopsy revealed an aspergilloma of the middle ear. The pre- and post-operative management, as well as treatment strategies, are discussed.

Conclusion:

To our knowledge, this is the first documented case of an aspergilloma of the middle ear with associated facial palsy. Readers are asked to consider this rare diagnosis in patients with suspected malignant otitis externa not responding to standard treatment.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Soubani, AO, Chandrasekar, PH. The clinical spectrum of pulmonary aspergillosis. Chest 2002;121:1988–99CrossRefGoogle ScholarPubMed
2 Supiyaphun, P, Sampatanukul, P, Sukumalpaiboon, P. Benign Aspergillus colonization (aspergilloma) in the middle ear. Otolaryngol Head Neck Surg 2001;125:281–2CrossRefGoogle ScholarPubMed
3 Supiyaphun, P, Sampatanukul, P, Vongfu, S, Kerekhanjanarong, V. Aural aspergilloma: an unusual delayed complication of tympanoplasty. J Med Assoc Thai 2003;86:S358–61Google ScholarPubMed
4 Hospenthal, DR, Kwon-Chung, KJ, Bennett, JE. Concentrations of airborne Aspergillus compared to the incidence of invasive aspergillosis: lack of correlation. Med Mycol 1998;36:165–8CrossRefGoogle Scholar
5 Latgé, J-P. Aspergillus fumigatus and aspergillosis. Clin Microbiol Rev 1999;12:310–50CrossRefGoogle ScholarPubMed
6 Grosjean, P, Weber, R. Fungus balls of the paranasal sinuses: a review. Eur Arch Otorhinolaryngol 2007;264:461–70CrossRefGoogle ScholarPubMed
7 Dufour, X, Kauffmann-Lacroix, C, Ferrie, JC, Goujon, JM, Rodier, MH, Karkas, A et al. Paranasal sinus fungus ball and surgery: a review of 175 cases. Rhinology 2005;43:34–9Google ScholarPubMed
8 Kurnatowski, P, Filipiak, A. Otomycosis: prevalence, clinical symptoms, therapeutic procedure. Mycosis 2001;44:472–9CrossRefGoogle ScholarPubMed