Korean J Otorhinolaryngol-Head Neck Surg.  2012 Nov;55(11):732-735. 10.3342/kjorl-hns.2012.55.11.732.

A Case of Unexpected Cotton Swap Foreign Body in the Ear Canal Causing Otogenic Skull Base Osteomyelitis

• Nam SW
• Kim DR
• Kim HJ
• Hong SK

• KMID: 2277432
• DOI: http://doi.org/10.3342/kjorl-hns.2012.55.11.732

Abstract

Otogenic skull base osteomyelitis (SBO) is a rare but life threatening disease, usually originating from a preceeding infection of the ear canal. It occurs dominantly in the elderly with diabetes or immunocompromised patients. However, foreign bodies in the ear canal may be a contributory factors causing otogenic SBO in healthy subjects. We describe a case of a previously healthy 51-year-old man, who was diagnoised with otogenic SBO after a physical exam and MRI scan. The patient complained of progressive otalgia lasting for one year and facial palsy that occurred three days before the visit. During the hospital course, an unexpected cotton swab was found in the ear canal. This was highly suspected as the main cause of otogenic SBO because, in the course of careful history taking, the patient remembered clearly that the cotton part of a cotton swab broke off in his ear a year ago. This case suggests that attention should be paid to high index suspicious foreign bodies in healthy subjects who are diagnosed with otogenic SBO, and extensive history taking and physical exam should be directed to this area.

Keyword

Ear canal; Foreign body reaction; Osteomyelitis; Skull base

MeSH Terms

Aged
Ear
Ear Canal
Earache
Facial Paralysis
Foreign Bodies
Foreign-Body Reaction
Humans
Immunocompromised Host
Magnetic Resonance Imaging
Middle Aged
Osteomyelitis
Skull
Skull Base