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

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.