Aspergilloma of the middle ear mimicking necrotising otitis externa: case report.
OBJECTIVE
We report a case of a patient who presented with otalgia and facial nerve palsy secondary to an aspergilloma of the middle ear.


METHODS
A 72-year-old, diabetic man presented to the ENT department with a history of worsening right-sided otalgia, aural discharge and hearing loss, associated with a right-sided facial weakness. This was assumed to be secondary to malignant otitis externa, and treatment was commenced. Imaging showed soft tissue within the middle ear and no bony erosion. Surgical exploration and biopsy revealed an aspergilloma of the middle ear. The pre- and post-operative management, as well as treatment strategies, are discussed.


CONCLUSIONS
To our knowledge, this is the first documented case of an aspergilloma of the middle ear with associated facial palsy. Readers are asked to consider this rare diagnosis in patients with suspected malignant otitis externa not responding to standard treatment.
Department of Otorhinolaryngology - Head and Neck Surgery, Derriford Hospital, Plymouth, UK. paul.rainsbury@nhs.net
P
P
Rainsbury
A
A
Mitchell-Innes
H
H
Wilson
M
M
Prior
D000368:Aged; D001228:Aspergillosis / Q000175:diagnosis; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D003937:Diagnosis, Differential; D004129:Dimethylpolysiloxanes / Q000627:therapeutic use; D004432:Ear, Middle; D004433:Earache / Q000209:etiology; D005158:Facial Paralysis / Q000209:etiology*; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D008297:Male; D009336:Necrosis; D010032:Otitis Externa / Q000175:diagnosis*
D004129:Dimethylpolysiloxanes; C013830:baysilon