Surgical Emphysema Following Canalplasty for Aural Exostoses
| Autor: | Sean Wise, Michael Baxter, Matthew W. Keller, Anil N. Shah |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Fossa Hearing loss Mandible 03 medical and health sciences Postoperative Complications 0302 clinical medicine medicine Humans Postoperative Period Exostoses Hearing Loss 030223 otorhinolaryngology Surgical emphysema Emphysema Crepitus Temporomandibular Joint biology business.industry Temporal Bone Soft tissue Middle Aged biology.organism_classification Sensory Systems Surgery Temporomandibular joint Cartilage Treatment Outcome medicine.anatomical_structure Otorhinolaryngology Earache Neurology (clinical) medicine.symptom Presentation (obstetrics) Tomography X-Ray Computed business Ear Canal 030217 neurology & neurosurgery Subcutaneous emphysema |
| Zdroj: | Otology & Neurotology. 38:1174-1177 |
| ISSN: | 1537-4505 1531-7129 |
| DOI: | 10.1097/mao.0000000000001512 |
| Popis: | OBJECTIVE To describe the presentation and management of surgical emphysema involving the temporomandibular joint and deep neck following exostoses removal. PATIENT A 60-year-old male surfer presented with hearing loss and recurrent infections in the right ear. An examination revealed obstructing bony exostoses in the right external auditory canal. He underwent right canalplasty using a postauricular approach. At 5 weeks after surgery, he presented with right otalgia, swelling of the right face and neck, and complaints of a squeaking noise in the right ear with mandibular excursions. An otomicroscopic examination demonstrated a focal area of prolapsing soft tissue along the anterior bony external auditory canal with mandibular movement. The examination also revealed palpable crepitus of the right face and neck. Computed tomography was obtained of the temporal bones and neck confirming a focal anterior canal wall defect allowing communication between the glenoid fossa and external auditory canal with subcutaneous emphysema tracking around the temporomandibular joint into the masticator, parotid, and parapharyngeal spaces. INTERVENTION Maxillomandibular fixation for 2 weeks with revision canalplasty using a split tragal cartilage graft. RESULTS At 6 weeks after revision surgery, the patient reported complete resolution of all symptoms. Repeat imaging demonstrated complete resolution of subcutaneous and deep neck emphysema, and the otomicroscopic examination revealed a fully epithelialized external auditory canal with no further evidence of soft tissue prolapse. CONCLUSION Maxillomandibular fixation with autologous cartilage graft is an effective management strategy for complications of canalplasty resulting in exposure of the temporomandibular joint capsule and surgical emphysema. |
| Databáze: | OpenAIRE |
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