Mycotic Infection of the Middle Ear and the Temporal Bone

บทคัดย่อ

Mycotic infection of the middle ear , inner ear and the temporal bone are extremely rare. The causative organisms include the Mucor species, Aspergillus species, Candida species, Blastomyces species and Cryptococcus species. It usually present in the patient with chronic illness such as diabetes mellitus , cirrhosis and drug addiction. Long standing steroid treatment and cytotoxic agents are also complicated by these organisms

Two cases of the middle ear and the temporal bone mycosis are presented. The first case was a 60-year-old man with middle ear and facial nerve aspergillosis. He was treated initially with amphotericin B and radical mastoidectomy . Finally , the facial-hypoglossal nerve crossover was done as a reconstructive measure. Facial contour and function were acceptable within 6 months postoperatively.

The second case was 36-year-old man who had multiple cranial nerve palsies ( cranial nerve 5, 7, 9, 10, 11 and 12 ) secondary to aspergillous granuloma of the middle cranial fossa, skull base and the petrous bone. A full course of amphotericin B therapy was introduced in this case. The disease was controlled by this mean.