Double Trouble of Double Fistulae

Deviprasad Dosemane,Pooja Nambiar,Shreyanshi Gupta,Ria Mukherjee,Meera Niranjan Khadilkar

doi:10.51248/.v41i1.556

Abstract

The complications of attico-antral type of Chronic Suppurative Otitis Media (CSOM) are severe due to underlying bone erosion. We describe a case of a 40-year-old lady with attico-antral CSOM and mastoiditis with a postauricular fistula, who underwent modified radical mastoidectomy with excision of the postauricular cutaneous mastoid fistula. Interestingly, another fistula over the dome of lateral semicircular canal was noted intraoperatively.Few reports of occurrence of postauricular mastoid fistula with a labyrinthine fistula have been documented.

Highlights

Chronic Suppurative Otitis Media (CSOM) is a chronic infection of the middle ear cleft that includes pharyngotympanic tube, mesotympanum, epitympanum, aditus and mastoid antrum [1]. It has been categorized into safe/ tubotympanic disease (TTD) and unsafe/ attico-antral disease (AAD)
We report a case of AAD with a postaural fistula complicated by a labyrinthine fistula
A postauricular mastoid-cutaneous fistula is an unusual condition that may arise due to chronic suppurative otitis media, tubercular otitis media, congenital cholesteatoma, mastoidectomy, extensive meatoplasty, or even natural exteriorisation of cholesteatoma from mastoid through postaural skin owing to its destructive nature [2,3,4,5,6]

Summary

INTRODUCTION

Chronic Suppurative Otitis Media (CSOM) is a chronic infection of the middle ear cleft that includes pharyngotympanic tube, mesotympanum, epitympanum, aditus and mastoid antrum [1]. It has been categorized into safe/ tubotympanic disease (TTD) and unsafe/ attico-antral disease (AAD). Granulation tissue was present over the right posterosuperior bony external auditory canal wall (Fig. 2), due to which the right tympanic membrane could not be visualised. A diagnosis of bilateral CSOM, right AAD, active stage, left TTD, inactive stage with bilateral mixed hearing loss (right more severe than left) with right postauricular cutaneous mastoid fistula and right acute mastoiditis was established. The patient was on regular follow up for the last one year with no evidence of recurrence

DISCUSSION

Findings

CONCLUSION