耳管通気後の咽喉頭粘膜下・頚部皮下出血例

Abstract

Inflation of the eustachian tube is often applied in the treatment of exudative otitis media and obstruction of the eustachian tube. However, complications following treatment have been occasionally reported and we encountered a rare case which developed a swelling in the neck, dyspnea, and hemorrhage in the deep neck, following application of inflation of the eustachian tube. A finding suggestive of bleeding was obtained by CT and MRI of the neck. Nasopharyngeal fiberscopy revealed extensive submucosal hemorrhage near the tubal orifice.Treatment with steroids, antibiotics and hemostypic was based on initiated immediately. The symptoms remitted on the next day. Anatomical relationships and earlier reports of similar cases, the internal carotid artery and its branches were considered to be the source of hemorrhage. The route of out flow was estimated accordingly. Although such a complication often results from carelessness in treatment, this patient had diabetes mellitus and osteoporosis as underlying diseases. A diabetic vascular disorder was suspected to be involved in the development of extensive hemorrhage. This case was presented to point out the importance of recognizing the coexisting basic disease, in cases such as this.