外耳道の特発性壊死性骨炎

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  • Benign necrotizing osteitis of the external auditory meatus; A case report.

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A 59-year-old man came to our clinic with complaints of itching, otalgia and otorrhea of the left ear for three months. An ulcer was found in the osseous portion of the left external canal. It was located on the postero-inferior wall of the canal about 7-8mm from the ear drum. Fragments of necrotized bone and bloody pus were prescnt in the ulcer. Staphylococcus epidcrmidis was isolated in a culture of the pus. In spite of conservative therapy for one month, nccrotized bone fragments could be removed easily from the ulcer, and the bony defect became larger. Therefore, surgical removal of the necrotized bony external canal was performed, and the wound was covered with a pedicled flap from the temporal muscle. The extracted specimen contained necrotic bone and fibrotic granulation. The diagnosis was benign necrotizing osteitis of the external auditory meatus. There was no recurrence during the 21-month postoperative follow-up. This disease causes ulceration and necrosis of the osseous external auditory meatus. It is clinically rare, and differentiation from cholesteatoma of the external meatus is often difficult.

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