Auricular Swelling Research Articles

Alpha-Pinene-encapsulated lipid nanoparticles diminished inflammatory responses in THP-1 cells and imiquimod-induced psoriasis-like skin injury and splenomegaly in mice

IntroductionPsoriasis, a persistent skin condition caused by the disorder of the immune system, impacts approximately 1.25 million individuals globally. Nevertheless, the presence of adverse effects in conventional clinical drugs necessitates further exploration of novel medications or combination therapies to mitigate these reactions and enhance their effectiveness.MethodsHence, our intention here in this paper is to utilize the lipid nanoparticle delivery system for overcoming the volatility and hydrophobic properties of α-pinene, a naturally occurring compound renowned for its anti-inflammatory and antiviral effects, and further explore its potential pharmacological applications both in vitro and in vivo.ResultsThe production of α-pinene lipid nanoparticles (APLNs) was achieved through the utilization of high pressure homogenization methods. APLNs was successfully fabricated with enhanced stability and water solubility. Meanwhile, the application of APLNs could drastically reduce the expression of lipopolysaccharide (LPS)-induced inflammation-related factors in THP-1 cells. Administration of APLNs to a mouse model of auricular swelling could effectively reduce redness and swelling in the auricles of mice as well. Furthermore, APLNs were also found to alleviate skin damage in mice with Imiquimod (IMQ)-induced psoriasis model, as well as decrease the levels of psoriasis-related protein nuclear factor kappa-B (NF-κB) and interleukin-17 (IL-17), interleukin-23 (IL-23), and other inflammation-related cytokines. More importantly, utilization of APLNs successfully mitigated the systemic inflammatory reactions in mice, resulting in the reduction of spleen-to-body ratio (wt%) and of inflammatory cytokines’ expression in the serum.DiscussionOverall, our results suggest that with the help of lipid nanoparticle encapsulation, APLNs possess a better pharmacological effect in anti-inflammation and could potentially serve as an anti-psoriasis drug.

Cutaneous tuberculosis of the pinna: A rare entity

IntroductionCutaneous tuberculosis (CTB) is a rare form of extrapulmonary tuberculosis (TB), accounting for only 1% to 2% of all extrapulmonary cases. It typically affects the face, and to a lesser extent, the neck or chest, with a higher incidence among young women. In Malaysia, TB is endemic; however, CTB involving the pinna is exceptionally rare. Consequently, there is often a delay in diagnosis and treatment due to frequent.AimThis case report aims to emphasize the presentation, diagnosis, and subsequent management of cutaneous pinna tuberculosis, supplemented by a review of the existing literature on this disease.Case studyWe present an 83-year-old patient with painful left auricular swelling and deformity and pus discharge for 4 months. His condition did not improve despite prolonged antibiotics treatment and multiple incision and drainage done.Results and discussionExamination under anaesthesia, wound exploration extended incision and drainage was performed, revealing auricular cartilage necrosis, tissue biopsy confirmed the presence of <i>Mycobacterium tuberculosis</i>.Conclusions(1) A non-healing auricular wound despite adequate antibiotics treatment should raise suspicion of TB. (2) Bactec is the most rapid and sensitive culture for tuberculosis. (3) Complications of pinna TB include pain, non-healing wound and permanent ear deformity.

Kimura’s disease: rare inflammatory condition mimicing as soft tissue neoplasm

Kimura’s disease is rare benign chronic inflammatory condition of unknown etiology involving head and neck region. The characteristic features of this condition are elevated serum IGE levels and microscopic picture reveals lymphoid proliferation with eosinophilic infiltration. It is commonly misdiagnosed as soft tissue neoplasm. Surgical wide local excision is the main stay of treatment. Sometimes combined therapy (excision and postoperative radiotherapy) is needed. Here we are presenting one interesting rare case, 32-year-old male with post auricular swelling, diagnosed as soft tissue tumor preoperatively, after excision came out as kimura’s disease.

Anti-inflammatory effects and related mechanisms in vitro and in vivo of Hedychium coccineum rhizome essential oil

Ethnopharmacological relevanceHedychium coccineum rhizome is an anti-inflammatory ethnomedicine used to remedy inflammation-related swelling and bronchial asthma. Aim of the studyThe study aimed to analyze the phytochemical constituents of H. coccineum rhizome essential oil (EO) and evaluate its in vitro and in vivo anti-inflammatory effects and underlying mechanisms. Materials and methodsPhytochemical constituents of H. coccineum rhizome EO were analyzed using GC-FID/MS. In RAW264.7 macrophages induced by LPS, blockade of PGE2, NO, IL-1β, IL-6, and TNF-α secretion by H. coccineum rhizome EO was measured, and then Western blot, qRT-PCR, and immunofluorescent staining were used to evaluate its underlying mechanisms. Moreover, we used the xylene-induced ear edema model for testing anti-inflammatory potential in vivo and examined auricular swelling as well as tissue and serum contents of IL-1β, IL-6, and TNF-α. ResultsEO's main components were E-nerolidol (40.5%), borneol acetate (24.8%), spathulenol (4.5%), linalool (3.8%), elemol (3.5%), and borneol (3.4%). In RAW264.7 cells stimulated by LPS, EO downregulated the expression of pro-inflammatory enzyme (iNOS and COX-2) genes and proteins, thereby suppressing pro-inflammatory mediators (NO and PGE2) secretion. Simultaneously, it reduced TNF-α, IL-1β, and IL-6 release by downregulating their mRNA expression. Besides, H. coccineum EO attenuated LPS-stimulated activation of NF-κB (by reducing IκBα phosphorylation and degradation to inhibit NF-κB nuclear translocation) and MAPK (by downregulating JNK, p38, and ERK phosphorylation). In xylene-induced mouse ear edema, EO relieved auricular swelling and lowered serum and tissue levels of TNF-α, IL-1β, and IL-6. ConclusionsH. coccineum EO had powerful in vivo and in vitro anti-inflammatory effects by inhibiting MAPK and NF-κB activation. Hence, H. coccineum EO should have great potential for application in the pharmaceutical field as a novel anti-inflammatory agent.

RED EARS, RED EYES AND HEARING LOSS: A DIAGNOSTIC DILEMMA

Relapsing polychondritis (RP) is a disease that confounds clinicians worldwide due to the difficulty in confirming its diagnosis and determining the best treatment plan. We report a case of a 34-year-old lady who presented with bilateral inflamed auricular swelling and red eyes, which turned out to be relapsing polychondritis. The patient was successfully treated with long-term oral steroids and is on regular follow-up. This report highlights how the subtle signs of her condition were picked up, leading to her diagnosis of RP and the treatment regime that successfully reversed her symptoms. The challenge of picking up subtle signs of the disease is best met by working as a team in a multidisciplinary setting. A literature study shows that RP is a rare disease that can present with many symptoms.

Metabolomics of the anti-inflammatory effect of Pueraria lobata and Pueraria lobata var. Thomsonii in rats.

Pueraria lobata (Willd.) Ohwi and Pueraria lobata var. Thomsonii (Benth.) Maesen are essential medicinal and edible homologous plants widely cultivated in Asian countries. Therefore, P. lobata and P. thomsonii are widely used in the food, health products and pharmaceutical industries and have significant domestic and international market potential and research value. P. lobata and P. thomsonii have pharmacological effects in the clinic, such as antipyretic, analgesic, anti-inflammatory and antioxidant effects. These plants are commonly used in the treatment of inflammatory diseases and other related diseases. However, the potential mechanisms of the anti-inflammatory effects of P. lobata and P. thomsonii have not been elucidated. This study aimed to confirm the anti-inflammatory effects of P. lobata and P. thomsonii on inflammatory model diseases and to investigate the mechanism of their anti-inflammatory effects from the perspective of plasma metabolomics. First, P. lobata and P. thomsonii were identified by high‒performance liquid chromatography (HPLC). Second, we established the following three inflammation models: an acute inflammation model of auricular swelling in mice induced by xylene, an acute inflammation model of foot swelling in rats induced by carrageenan gum, and a chronic inflammation model of cotton ball granuloma in rats. Then we examined the weight and swelling rate of auricular swelling in mice; the residence time, contact area, and mean contact pressure in rats on the gait meter; and the weight of granulomas in rats and the content of IL-1β and TNF-α in plasma to investigate the anti-inflammatory pharmacodynamics of P. lobata and P. thomsonii. Third, we used LC‒MS‒based plasma metabolomics techniques to obtain potential biomarkers of P. lobata and P. thomsonii related to inflammation. Then, the potential biomarkers were enriched by MetaboAnalyst and KEGG metabolomics analysis tools to obtain metabolic pathways related to inflammation. Finally, we tested the indicators of COX-2, 5-LOX, GSH, GSSG and γ⁃GCL in rat plasma from the granuloma model by enzyme-linked immunosorbent assays (ELISAs) to verify the inflammation-related metabolic pathway. The experimental results showed that P. lobata and P. thomsonii could reduce the swollen weight and swelling rate of the auricle in mice, and could increase the residence time, contact area and mean contact pressure in rats on the gait meter. Moreover, P. lobata and P. thomsonii could inhibit the growth of granulomas and reduce the content of IL-1β and TNF-α in plasma in rats. The above results preliminarily verified that P. lobata and P. thomsonii have different anti-inflammatory effects. We identified eighteen plasma biomarkers associated with P. lobata and sixteen plasma biomarkers related to P. thomsonii in regulating inflammation by a plasma metabolomics analysis. The following two major metabolic pathways were further screened and enriched: arachidonic acid metabolism and glutathione metabolism. Then we noted that P. lobata and P. thomsonii could reduce the COX-2, 5-LOX and GSSG levels and increase the GSH, GSH/GSSG and γ⁃GCL levels based on the ELISA results, which demonstrated that P. lobata and P. thomsonii affect the anti-inflammatory mechanism through arachidonic acid metabolism and glutathione metabolism. The results of this study further elucidate the anti-inflammatory mechanism of action of P. lobata and P. thomsonii, providing a scientific basis for developing new drugs for the treatment of inflammation-related diseases and laying a foundation for the development of herbal resources, such as P. lobata and P. thomsonii.

Complicated Trichosporon asahii mastoiditis in immunocompetent child

BackgroundTrichosporon asahii is an opportunistic fungus that causes infections in immunosuppressed patients. It is rarely seen in children and immunocompetent hosts. The mortality rates are still high despite early treatment with proper antifungal drugs. Trichosporon asahii mastoiditis in an immunocompetent child makes this case challenging.Case presentationThis report presents a case of Trichosporon asahii mastoiditis which was complicated by transverse sinus thrombosis, in an otherwise healthy 21-month-old girl, and successfully treated with voriconazole. Trichosporon asahii was isolated, in three different occasions, from ear discharge of an immunocompetent healthy child, who presented with prolonged history of fever and received appropriate dosages of multiple types of antimicrobials as an outpatient but without improvement. After 48 h of starting the Voriconzole; post auricular swelling and ear discharge improved significantly.ConclusionA high index of clinical and microbiological suspicion is needed for optimal diagnosis of Trichosporon infection. Trichosporon asahii can also cause infection in immunocompetent individual even without previous history of hospitalization or intervention. We emphasize the importance of early pediatric infectious evaluation and intervention.

Burn Ointment Promotes Cutaneous Wound Healing by Modulating the PI3K/AKT/mTOR Signaling Pathway.

Burn ointment (BO) is a clinically useful medicine for the treatment of burns and scalds. However, there is no enough scientific evidence to report the effect of BO on wound healing and its analgesic and anti-inflammatory efficacy. The aim of this work was to evaluate the anti-inflammatory and analgesic efficacy of BO and to reveal the potential wound healing properties and related mechanisms of BO. In this work, the content of active ingredients of BO was determined by high-performance liquid chromatography (HPLC). Two animal models of inflammation were used to study its anti-inflammatory activity, and a hot plate method was used to evaluate its analgesic effect. In addition, mouse incision and rat burn models were used to investigate the effect of BO on the anti-inflammatory and wound healing mechanisms. The results showed that BO was safe for topical application, and BO could significantly inhibit auricular swelling in mice and paw swelling in rats and significantly prolong the latency period of paw licking in the hot plate experiment in mice. It can also accelerate wound healing and repair scars by promoting the formation of new epithelial tissues in rat burn models. In addition, BO significantly downregulated the serum level of TNF-α and significantly increased the serum levels of VEGF and TGF-β1. Also, BO promoted the expression of collagen I and increased the ratio in p-PI3K/PI3K, p-AKT/AKT, and p-mTOR/mTOR pathways. Our results demonstrate the safety and efficacy of BO and suggest that activation of the PI3K/AKT/mTOR signaling pathway may play an important role in the promotion of wound healing by BO.

Volatile Oil of Platycladus Orientalis (L.) Franco Leaves Exerts Strong Anti-inflammatory Effects via Inhibiting the IκB/NF-κB Pathway

This study was designed to investigate the anti-inflammatory effects of volatile oil of Platycladus orientalis (L.) Franco leaves (VOPF) and the underlying molecular mechanisms by using the non-infectious inflammation rat models and infectious inflammation mouse models. Ear swelling and intraperitoneal capillary permeability in mice, and carrageenan-induced toe swelling and cotton ball-induced granuloma in rats were used to reveal anti-inflammatory effects of VOPF. Moreover, the lipopolysaccharide (LPS)-induced mouse model of acute lung injury was used to explore the anti-inflammatory mechanism of VOPF. The results showed that VOPF could significantly inhibit auricular swelling, intraperitoneal capillary permeability in mice, and reduce granuloma swelling and paw swelling in rats. Furthermore, it significantly alleviated the pathological damage of the lung tissue. In addition, VOPF could reduce the contents of IL-1β and TNF-α and increase the content of IL-10 in the serum. It had little effect on the expression of p65 but reduced the phosphorylation level of p65 and IκB in NF-κB pathway. In conclusion, VOPF has anti-inflammatory effects and the mechanisms involve the down-regulation of the phosphorylation levels of p65 and IκB and blockage of the NF-κB signaling pathway.

Diagnosis of Cysticercosis in post auricular swelling on FNAC- A case report

Introduction: Cysticercosis, a parasitic tissue infection is caused by larva of Taenia solium (Cysticercus cellulosae). Fine needle aspiration cytology (FNAC) provides direct, specific, simplest and early diagnosis of cysticercosis and remains one of the ideal diagnostic procedure wherever the lesion can be approached easily. Case Report: We present a case of 21 year old female presented with swelling on left postauricular area for one month, which was 2×1 cm, firm, tender and mobile. USG was suggestive of infective aetiology. FNAC was done using 24-gauge needle. Whitish blood mixed aspirate was seen. Smears were wet fixed with 95% ethyl alcohol and stained with Papanicolaou stain. Cytology smears showed fragments of bluish fibrillary material with interspersed small nuclei, which were seen against background of mixed inflammatory infiltrate of neutrophils, histiocytes, lymphocytes and eosinophils. Essential for diagnosis of cysticercosis are identification of parasitic fragments which may comprise bluish, fibrillary structures, sometimes with honeycombing, calcospherules, teguments, scolex with hooklets and hyaline membrane surrounding it. Conclusion: Fine needle aspiration cytology is a low cost, outpatient procedure which helps in early diagnosis of cysticercosis. A careful search for parasitic fragments is to be made in presence of polymorphous inflammatory infiltrate composed predominantly of neutrophils, histiocytes and eosinophils. Keywords: Cysticercosis, Cytology, Inflammation, Fibrillary material.

Kimura’s disease as an uncommon cause of post auricular swelling

<p>Kimura’s disease (KD) is a rare chronic inflammatory disorder of unknown etiology, primarily seen in young Asian males. In India, only 200 cases have been reported worldwide since its histopathological diagnosis. The disease is characterized by painless subcutaneous swelling in head & neck region, blood and tissue eosinophilia and raised Immunoglobulin E (IgE) levels. A systematic multidisciplinary approach is mandatory to rule out the other common causes of post auricular lymphadenopathy. The diagnosis of KD can be difficult and misleading and patients with this disease are often evaluated using avoidable procedures by just not being aware of KD. Here, we present a case of a 20 year old male who presented with nodular swellings in the bilateral post auricular region. The diagnosis of KD was done based on characteristic histopathologic finding in conjunction with peripheral eosinophilia.</p>

Analgesic and anti-inflammatory effects and mechanism of action of borneol on photodynamic therapy of acne

This study aims to explore the analgesic and anti-inflammatory effects of borneol, a traditional Chinese medicine, on photodynamic treatment of acne. Here, we found that borneol significantly decreased the auricular swelling rate and pain threshold of rats. We also showed that borneol noticeably reduced macrophage and lymphocyte infiltration. The number of Th cells was significantly higher in the control PDT group than in the PDT plus borneol treatment group (P < 0.05). The expression of IL-6, TNF-α, and IL-8 mRNA and proteins were noticeably lower in the treatment group in comparison to those of the PDT control group, while PDT plus borneol activated the p38-COX-2-PGE2 signaling pathway, increasing expression in the treatment group. Borneol has significant analgesic and anti-inflammatory effects on PDT of acne, and enhances the healing of acne by activating p38-COX-2-PGE2 signaling pathway.

Anti-Nociceptive and Anti-Inflammation Effect Mechanisms of Mutants of Syb-prII, a Recombinant Neurotoxic Polypeptide.

Syb-prII, a recombinant neurotoxic polypeptide, has analgesic effects with medicinal value. Previous experiments indicated that Syb-prII displayed strong analgesic activities. Therefore, a series of in vivo and vitro experiments were designed to investigate the analgesic and anti-inflammatory properties and possible mechanisms of Syb-prII. The results showed that administered Syb-prII-1 and Syb-prII-2 (0.5, 1, 2.0 mg/kg, i.v.) to mice significantly reduced the time of licking, biting, or flicking of paws in two phases in formalin-induced inflammatory nociception. Syb-prII-1 inhibited xylene-induced auricular swelling in a dose-dependent manner. The inhibitory effect of 2.0 mg/kg Syb-prII-1 on the ear swelling model was comparable to that of 200 mg/kg aspirin. In addition, the ELISA and Western blot analysis suggested that Syb-prII-1 and Syb-prII-2 may exert an analgesic effect by inhibiting the expression of Nav1.8 and the phosphorylation of ERK, JNK, and P38. Syb-prII-1 markedly suppressed the expression of IL-1β, IL-6, and TNF-α of mice in formalin-induced inflammatory nociception. We used the patch-clamp technique and investigated the effect of Syb-prII-1 on TTX-resistant sodium channel currents in acutely isolated rat DRG neurons. The results showed that Syb-prII-1 can significantly down regulate TTX-resistant sodium channel currents. In conclusion, Syb-prII mutants may alleviate inflammatory pain by significantly inhibiting the expression of Nav1.8, mediated by the phosphorylation of MAPKs and significant inhibition of TTX-resistant sodium channel currents.

Bezold Abscess in a patient with Juvenile Rheumatoid Arthritis

A Bezold abscess is a rare complication of acute otitis media and mastoiditis which is characterized by the collection of pus in the sub-muscular spaces from the mastoid cavity. A 27-year-old female with history of Juvenile Rheumatoid Arthritis presented with right ear discharge and post auricular swelling extending along the sternocleidomastoid muscle. A Bezold abscess was diagnosed upon review of the patient’s CT scan. She subsequently underwent incision and drainage of the abscess in addition to a cortical mastoidectomy. Although the development of intra and extra axial complications of acute otitis media are very rare in the post antibiotic and vaccination era, it should be noted that a compromised immune system is a significant risk factor for this complication.

Primary tubercular otitis media: a rare case report

&lt;p class="abstract"&gt;Tubercular otitis media is a rare presentation of tuberculosis. High index of suspicion is required for diagnosis. We present a rare case of tubercular otitis media presenting as post auricular swelling with no evidence of pulmonary or any other foci of tuberculosis. Diagnosis was made on the basis of acid fast bacilli seen in fine needle aspirate. Anti-tubercular drugs were initiated and patient responded well to treatment.&lt;/p&gt;&lt;p class="abstract"&gt; &lt;/p&gt;

Recurrent auricular inflammation caused by Kimura's disease: reminiscent of the early phase of relapsing polychondritis?

Recurrent auricular inflammation with pain and swelling is due to the composition and environmental exposures experienced by the constituent parts of the ear. A painful, swollen ear may suggest acute perichondritis, subperichondrial hematoma or relapsing polychondritis (RP). Here, we report a case of a 51-year-old Asian man who had an approximately 2-year history of recurrent auricular swelling and was referred for suspected RP. Biopsy of the lesion revealed the formation of lymphoid follicles with a dense infiltrate of lymphocytes, histiocytes and eosinophils. His serum IgE level was 12 040 U/mL (normal range 0–358). These findings suggest that the patient had Kimura’s disease (KD). Physicians should be aware of KD as a potential cause of recurrent auricular inflammation.

The diagnosis and treatment of a variant type of auricular sinus: postauricular sinus.

To make otolaryngologists aware of the variant types of auricular sinus, we have performed a systematic review of patient diagnoses and presented our operative experiences. From 2009 to 2013 in Sun Yat-Sen Memorial Hospital, there was a total of 20 children with the variant type of auricular sinuses including the comprehensive group. Postauricular sinuses have pits located posterior to the imaginary vertical line that is tangent to the external auditory canal. Sinuses that penetrate the cartilage and cause postauricular swelling or skin defects characterize type 1 of the variant type, while sinuses that adhere to the cartilage and cause preauricular or auricular swelling or skin defects characterize type 2. Patients with pits both anterior to and posterior to the imaginary vertical line comprise the comprehensive group. The patients who had infected underwent auricular sinusectomy using a dual approach, with accurate fistula tracing and proper cartilage removal. Sixteen children who had infected sinus underwent surgery, while the other four were asymptomatic. Ten children (62.5%) of 16 patients were diagnosed as type 1 of the variant type, 2 (12.5%) as type 2. Four children (25%) were diagnosis as the comprehensive group. The asymptomatic could not be defined as the sinuses location were unknown. Sixteen children (100%) of 16 patients who underwent surgery had a history of misdiagnosis and treatment. These patients did not experience recurrence over a 5-year follow-up period. The locations of pits and sinuses help to categorize the different types of auricular sinus. The effective method that we have described should be considered a viable way to reduce recurrence.

A comparative assessment of acute oral toxicity and traditional pharmacological activities between extracts of Fritillaria cirrhosae Bulbus and Fritillaria pallidiflora Bulbus

Ethnopharmacological relevanceFritillariae Bulbus (“Beimu” in Chinese) is a famous traditional Chinese medicine used to treat cough, expectoration and asthma for more than 2000 years, which belongs to the Fritillaria genus in Liliaceae family. Bulbs of Fritillaria cirrhosa D.Don (BFC) and bulbs of Fritillaria pallidiflora Schrenk (BFP) are two important drugs of Beimu. Due to the significant similarities in their outward appearance characters and chemical profiles, BFC has often been adulterated with BFP in Chinese Traditional Medicine markets. Aim of the studyThis study aims to compare the oral acute toxicity and the traditional pharmacological activities including antitussive, expectorant and anti-inflammatory effects between the extract of BFC and BFP, to clear and definite if the BFP can be used as a substitute of the BFC in the application of traditional medicine. Materials and methodsThe extracts were prepared through refluxing with 80% ethanol solvent. For the acute toxicity tests, graded doses of BFP extracts and the maximum dose of BFC extracts were administered orally to mice. The animals were observed for toxic symptoms and mortality daily for 14 days. For the pharmacological activities tests, graded doses of BFP and BFC extracts were administered orally to mice. To observe the effects relieving cough, expelling phlegm and lessening the ear swelling of BFC extracts and BFP extracts through ammonia liquor inducing cough, phenol red apophlegmating in mice and the xylene-induced auricular swelling of mouse, respectively. ResultsIn the acute toxicity study, the LD50 value of BFP in mice was calculated to be 213.57 g/kg body weight, and the maximum feasible dose (MFD) value of BFC in mice was 452.14 g/kg. Histopathological analysis has shown inflammatory cells infiltration and cells edema in liver, multinucleated giant cell proliferation in spleen, perivascular exudate and hemorrhage in lung, glomerulus atrophy in kidney of mice after oral administrations of BFP extracts. But only liver cells edema was observed in BFC group. Both BFC extract and BFP extract significantly increased latent period of cough and inhibited cough frequency in mice induced by ammonia. Besides, the two extracts also obviously enhanced mice's tracheal phenol red output in expectorant assessment and inhibited the development of ear edema in anti-inflammatory evaluation assay. ConclusionTo summarize, the BFP has the significant similarities in morphological characteristics, chemical profiles and traditional pharmacological activities compared with the BFC. The result of this study provide some valid scientific support for using BFP as a plant substitute of the BFC, but considering the toxicity of BFP is much higher than BFC, we don't recommend long-term oral administration of BFP or exceeding recommended dosage of Chinese Pharmacopoeia 2015.

Differential Diagnosis of Post Auricular Swelling with Mastoid Bone Involvement.

Post auricular swelling with mastoid bone involvement most commonly occurs as a cranial complication of chronic or acute suppurative otitis media. Aim of this study, to detect etiology of postauricular swelling with mastoid bone involvement. This is a retrospective study which was done on all patients whom underwent mastoidectomy for post auricular swelling with mastoid bone involved in El Minia University Hospital from January 2014 to June 2017. A total of 49 patients were identified in this study, 23 males and 26 females, their ages ranged 5-28years old with a mean of 25.8years old. Group A: these were 45 patients with a history of otorrhea (chronic suppurative otitis media), of 3months to 4years duration. Group B: these were four patients without any history of otorrhea. Two patients diagnosed as acute otitis media, one patient diagnosed as Langerhans cell histiocytosis and one patient diagnosed as fungal mastoiditis. Chronic suppurative otitis media is the most common causes of postauricular swelling. Langerhans cell histiocytosis of the temporal bone and fungal mastoiditis are considered a rare presentation of postauricular swelling.

Langerhans Cell Histiocytosis in Temporal Bone: Case Report

Langerhans cell histiocytosis (LCH) is a rare disorder characterized by uncontrolled proliferation of Langerhans cells. We report a case of a 5-years old girl with left post auricular swelling, otalagia and otorrhea of 2 month duration, High resolution computed tomography of temporal bone show destructive expanding tissue density mass. Apparent diffusion coefficient is 1.08×10³ mm²/s in diffusion weight magnetic resonance imaging .Post auricular incision revealed a pinkish, firm granulomatous mass occupied middle ear and mastoid Histopathological examination revealed a mixture of Langerhans histocytes and eosinophils. CD1 and S100 are positive in mmunohistochemistry.