title: Masticator Space Foreign Body in a Child Presenting With Otorrhea and Granulation Tissue of the External Auditory Canal.
abstract: OBJECTIVE
  We report an unusual case of masticator space foreign body in a patient presenting with otorrhea and granulation tissue within the external auditory canal (EAC).
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A 16-month-old male presented with fever, unilateral otorrhea, facial swelling, leukocytosis, and granulation tissue within the EAC that failed to respond to conventional medical treatment. Computed tomography scan showed EAC and middle ear opacification and soft tissue swelling involving the masticator space. Given concerns for malignancy, biopsies of tissue within the EAC and of a newly detected right buccal mass were performed, revealing granulation tissue. Concern persisted for neoplasm, however, and magnetic resonance imaging was obtained, showing a masticator space foreign body and possible osteomyelitis of the mandible and pterygoid plates. The patient underwent urgent operative removal of a 3 cm crayon fragment from the masticator space and debridement of granulation tissue arising from a small defect at the inferior medial cartilaginous EAC. He likely sustained foreign body injury several weeks earlier upon falling from standing height while biting a crayon. Postoperatively, he was observed in hospital on intravenous antibiotics and improved significantly. He has since fully recovered.
  
  
  CONCLUSIONS
  Masticator space foreign bodies may present with erosion and granulation tissue of the EAC.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA Division of Pediatric Otolaryngology-Head & Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Kareem.tawfik@uc.edu.
authors.forename: Kareem O
authors.initials: KO
authors.lastname: Tawfik
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA Division of Pediatric Otolaryngology-Head & Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Colin R
authors.initials: CR
authors.lastname: Edwards
authors.affiliation: Department of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Blaise V
authors.initials: BV
authors.lastname: Jones
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA Division of Pediatric Otolaryngology-Head & Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Myer
mesh_terms: D002610:Cheek / Q000000981:diagnostic imaging / Q000601:surgery*; D003646:Debridement; D004424:Ear Canal; D004427:Ear Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D004487:Edema / Q000209:etiology; D005547:Foreign Bodies / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006097:Granulation Tissue / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008410:Masticatory Muscles / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: and airway; ear canal; foreign bodies in the ear; granulation tissue; masticator space; nose; otorrhea