Chronic Suppurative Otitis Media Accompanied by Facial Nerve Paresis: A Case Report

Alia Oktarisa, Danisa Siregar
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Abstract

Introduction: Chronic suppurative otitis media (CSOM) is marked by ear discharge (otorrhea) that lasts for more than six to eight weeks, middle ear inflammation that doesn't go away, and a ruptured eardrum. The purpose of this study is to describe examples of CSOM with facial nerve paresis and how such cases are managed. Case presentation: A thirty-year-old man complained to the Mataram Community Health Center two days before admission that his mouth was turning to the left, despite the fact that he was still able to speak well. Additionally, for four months, the patient complained of a constant discharge from the right ear. The fluid that emerges from the ear is sticky, yellow, and odorous; blood is not mixed with it. Upon inspection, a cholesteatoma and a flat-edge attic perforation on the tympanic membrane were discovered, together with a purulent and odorous discharge in the ear canal of the right ear. After a facial nerve examination, it was discovered that the forehead wrinkles were uneven and that the face was asymmetrical, with the right eyebrow unable to be raised. The patient was identified as having peripheral facial nerve paresis and persistent suppurative malignant otitis media of the auricula dextra. The patient is being treated with irrigation of the ear canal with 0.9% NaCl, cleaning of the cholesteatoma, and antibiotic administration: two drops of ofloxacin ear drops given twice a day, three times a day ciprofloxacin tablets 500 mg, three times a day methylprednisolone 16 mg, and advice to undergo a mastoidectomy. Conclusion: Complications including hearing loss, facial nerve palsy, subperiosteal abscess, petrositis, meningitis, cerebral abscess, and labyrinthine fistula are indicated for mastectomy surgical therapy.
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伴有面神经麻痹的慢性化脓性中耳炎:病例报告
导言:慢性化脓性中耳炎(CSOM)的特征是耳部分泌物(耳脓)持续六至八周以上,中耳炎症久治不愈,鼓膜破裂。本研究旨在描述 CSOM 伴有面神经麻痹的病例,以及如何处理此类病例。病例介绍:一名 30 岁的男子在入院前两天向马打兰社区卫生中心抱怨说,尽管他仍然能够很好地说话,但他的嘴却向左偏。此外,四个月来,患者一直抱怨右耳有分泌物流出。耳内流出的液体粘稠、发黄、有异味,其中不混有血液。经检查,发现右耳耳道内有胆脂瘤和鼓膜平缘阁楼穿孔,以及脓性异味分泌物。面神经检查后发现,患者前额皱纹不均匀,面部不对称,右眉无法抬起。经鉴定,患者患有周围面神经麻痹和耳廓外侧持续性化脓性恶性中耳炎。目前正在对患者进行治疗,用 0.9% 氯化钠冲洗耳道,清理胆脂瘤,使用抗生素:每天两次,每次两滴氧氟沙星滴耳液;每天三次,每次 500 毫克环丙沙星片;每天三次,每次 16 毫克甲基强的松龙;并建议患者进行乳突切除术。结论并发症包括听力损失、面神经麻痹、骨膜下脓肿、颅底炎、脑膜炎、脑脓肿和迷走神经瘘,这些都是乳突切除手术治疗的适应症。
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