unsafe csom

Dr. Rishank Kishore Resident

ENT & Head-Neck Surgery

27/Male

Foul smelling lt. ear discharge for 2 years

Deviation of angle of mouth rt. side for 2 days

History of present illness:• Discharge was blood stained, foul smelling,

continuous, purulent in nature, scanty in amount without any associated URTI.

• Deviation of angle of mouth rt. side was sudden in onset and progressive.

• Patient was under treatment of a private practitioner, details of which are not available.

Personal History : Non alcoholic Non smoker

Past HistoryFamily History Not ContributoryDrug Allergy

Average built & nourished Vitals – WNL

Systemic Examination: normal

All blood & urine routine investigations were normal

Left unsafe chronic suppurative otitis media with facial palsy as a resultant complication.

The treatment for this condition is immediate mastoid exploration with decompression of the facial nerve.

MRM FACIAL NERVE DECOMPRESSION

It was found during surgery that vertical segment of facial nerve was compressed which is very uncommon.

Patient was operated within 2 days of presentation. So he started recovering soon after surgery, and recovered completely within one month.

Extra cranial: Mastoiditis Facial palsy Labyrinthitis

Intra cranial: Meningitis Extradural abscess Subdural abscess Lateral sinus

thrombophlebitis Temporal lobe

abscess Cerebellar abscess Otitic

hydrocephalus

With the advent of newer antibiotics and high resolution imaging techniques the incidence of complications of Chronic Suppurative Otitis media has become very rare.

It only occurs when there is some level of ignorance either at the level of the patient or the treating doctor.