Ramu presented with persistent ear discharge and hearing loss. Modified radical mastoidectomy was done to him. Patient comes back with persistent ear discharge and retro-orbital pain. What is your diagnosis:
(c) Petrositis(Ref. Cummings, 6th ed., 2165)Since the air cells of the petrous bone communicate with the mastoid, in any patient, if there is persistent ear discharge following cortical or modified radical mastoidectomy, petrositis should be ruled out by CT and MRI. Also retroorbital pain is suggestive of petrositis (due to involvement of ophthalmic division of trigeminal).Labyrinthitis per se does not lead to ear discharge once the middle ear and mastoid disease has been cleared by surgery. Moreover, in labyrinthitis there will be vertigo along with hearing loss. So this is not the complication in the given case.Latent mastoiditis or masked mastoiditis can be a consequence of inadequate medical management; but there is no question of it arising after modified radical mastoidectomy.
Diffuse serous labyrinthitis
Purulent labyrinthitis
Petrositis
Latent mastoiditis
Ear