Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-28T03:50:57.711Z Has data issue: false hasContentIssue false
  • English
  • Français

Gustatory otorrhoea: a rare case of congenital external ear salivary fistula

Published online by Cambridge University Press:  23 June 2009

N De Zoysa ,
S Vasani ,
S Kaniyur  and
A Frosh
N De Zoysa*
Affiliation:
Department of Otolaryngology, Lister Hospital, Stevenage, UK
S Vasani
Affiliation:
Department of Otolaryngology, Lister Hospital, Stevenage, UK
S Kaniyur
Affiliation:
Department of Radiology, Lister Hospital, Stevenage, UK
A Frosh
Affiliation:
Department of Otolaryngology, Lister Hospital, Stevenage, UK
*
Address for correspondence: Mr Nilantha De Zoysa, Department of Otolaryngology, Lister Hospital, Corey's Mill Lane, Stevenage SG1 4AA, UK. E-mail: neildezoysa@doctors.net.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

We present an extremely rare case of a 44-year-old woman with right gustatory otorrhoea and otalgia.

Case report:

The patient had been initially treated for otitis externa after Pseudomonas aeruginosa was grown from a microbiological swab. The otorrhoea fluid was collected and tested positive for amylase. Sialography and computed tomography imaging of the temporal bone confirmed a sialo-aural fistula from the right parotid gland to the bony external acoustic meatus. The defect was consistent with a patent foramen of Huschke. The fistula was identified surgically via a superficial parotidectomy approach, after contrast injection of Bonney's blue dye into the parotid duct, and then ligated and divided. The patient had immediate and sustained resolution of her otorrhoea.

Conclusions:

Sialo-aural fistulae are extremely rare, and usually arise as a complication of surgery or as an acquired disease process. To date, only four cases have been reported. This case demonstrates the use of sensitive investigation involving sialography and computed tomography, as well as successful surgical management, with complete resolution of symptoms.

Keywords

Parotid GlandExternal Auditory CanalFistulaOtorrhoea
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 12 , December 2009 , pp. 1371 - 1374
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Sharma, PD, Dawkins, RS. Patent foramen of Huschke and spontaneous salivary fistula. J Laryngol Otol 1984;98:83–5CrossRefGoogle ScholarPubMed
2Ars, B. Huschke's foramen [in French]. Acta Otorhinolaryngol Belg 1988;42:654–8Google ScholarPubMed
3Wang, RG, Bingham, B, Hawke, M, Kwok, P, Li, JR. Persistence of the foramen of Huschke in the adult: an osteological study. J Otolaryngol 1991;20:251–3Google ScholarPubMed
4Moreno, RC, Chilvarquer, I, Hayek, JE, Seraidarian, PI. Anatomic and radiograph study of the persistence of foramen of Huschke. Rev Bras Otorrinolaringol (Engl Ed) 2005;71:676–9CrossRefGoogle ScholarPubMed
5Yetiser, S, Tosun, F. Radiology quiz case 1: patency of Huschke foramen and fistula formation between the auditory canal and the parotid gland. Arch Otolaryngol Head Neck Surg 2003;129:594–6CrossRefGoogle ScholarPubMed
6Langer, J, Begall, K. Otosialorrhoea – diagnostics and therapy of a salivary fistula of the external auditory canal [in German]. Laryngorhinootologie 2004;83:606–9CrossRefGoogle ScholarPubMed
7Rushton, VE, Pemberton, MN. Salivary otorrhoea: a case report and a review of the literature. Dentomaxillofac Radiol 2005;34:376–9CrossRefGoogle Scholar
8Triglia, JM, Nicollas, R, Ducroz, V, Koltai, PJ, Garabedian, EN. First branchial cleft anomalies: a study of 39 cases and review of the literature. Arch Otolaryngol Head Neck 1998;124:291–5CrossRefGoogle ScholarPubMed
9Heffez, L, Anderson, D, Mafee, M. Developmental defects of the tympanic plate: case reports and review of the literature. J Oral Maxillofac Surg 1989;47:1336–40CrossRefGoogle ScholarPubMed
10Wittekindt, C, Schondorf, J, Stennert, E, Jungehülsing, M. Duplication of the external acoustic canal. A report of three cases. Int J Pediatr Otorhinolaryngol 2001;58:179–84CrossRefGoogle ScholarPubMed
11Rabinov, CR, Alavi, S, Canalis, RF, Lee, EJ. Recurrent pleomorphic adenoma of the parotid gland involving the osseous external acoustic canal. With a note on the foramen Huschke. Ann Otol Rhinol Laryngol 1997;106:589–93CrossRefGoogle ScholarPubMed
12Hawke, M, Kwok, P, Shankar, L, Wang, RG. Spontaneous temporomandibular joint fistula into the external acoustic canal. J Otolaryngol 1988;17:29–31Google Scholar
13Ali, TS, Rubinstein, JT. Rheumatoid arthritis of the temporomandibular joint with herniation into the external acoustic canal. Ann Otol Rhinol Laryngol 2000;109:177–9CrossRefGoogle Scholar