Md. Mofakkarul Islam
Jalalabad Ragib-Rabeya Medical College Hospital
Title: Squamous cell carcinoma in the tympanomastoid region mimicking as Malignant otitis externa- Experience of managing the patient at a rural developing medical institute in Bangladesh
Biography
Biography: Md. Mofakkarul Islam
Abstract
Cancer of the external auditory canal (EAC) and middle ear (ME) is rare, accounting for less than 1% of all head-and-neck malignancies of which squamous cell carcinoma (SCC) is the most common. Even though squamous cell carcinoma [SCC] of the middle ear and malignant otitis externa or Chronic supporative otitis media(CSOM) co-exist, no definitive correlation has been proven. Here we are presenting a case of an elderly patient who had been suffering with severe otalgia, profuse otorrhea,shortness of hearing, and associated facial palsy having predisposing factors such as Diabetes mellitus. Immune compromised states also be worked up for the diagnosis of malignant otitis externa or skull base osteomyelitis. A provisional diagnosis of malignant otitis externa and non responding chronic suppurative otitis media(CSOM) was made and treated accordingly but response of the treatment was not satisfactory. Then we further evaluate the patient as per the available logistics in this region e.g. CT scan,culture & sensitivity,viral culture, audiometry.And decided for exploring the mastoid and finally radical mastoidectomy was done. Histology of the explored mastoid specimen revealed Invasive squamous cell carcinoma grade-2, which was treated with radical radiotherapy. Objective of this presentation is to bring attention to the coexistence of malignant otitis externa, CSOM and squamous cell carcinoma ear and also the importance to detect these lesions at an early stage. This report also highlights the requirement of histopathological analysis in mastoidectomy and discusses the aetiology and management of squamous cell carcinoma of the middle ear in a rural developing medical institute where there were some challenges of shortages of skill medical personnel, less than expected health infrastructure, modern & updated equipment and required pathological support. Moreover must assemble logistics often not seen.