Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Otorrhea as a Resolution for a Parotid Abscess through an Unusual Natural Pathway: A Case Report and Recent Literature Review

Document Type : Case Report

Authors
Suhaili Zazali 1
Senthilraj Retinasekharan 2
1 Department of Otorhinolaryngology - Head and Neck Surgery, Kulliyah of Medicine, International Islamic University Malaysia, Bandar Indera Mahkota Campus, Jalan Sultan Ahmad Shah, 25200 Kuantan, Pahang.
2 Department of Otorhinolaryngology Head and Neck Surgery, Hospital Shah Alam, Persiaran Kayangan, Seksyen 7, 40000 Shah Alam, Selangor, Malaysia.
10.22038/ijorl.2021.58379.3014
Abstract
Introduction:
The connection between parotid gland and external auditory canal has long been described throughout the centuries. It can act as a gateway for infectious or neoplastic material to spread between those two structures.
 
Case Report:
To our surprise, this naturally occurring defect can serve as an option to conservatively treat a parotid abscess. We report a case of a parotid abscess with a concurrent presentation of an ipsilateral ear discharge. The purpose of our study is to highlight a unique process of resolution of parotid abscess through an opening in the ear canal.
Conclusions:
In spite of the fact that the fissure of Santorini is known as the gateway and tunnel for a disease to spread, it has proven to serve as a pathway for disease elimination as well.
Keywords
Parotid abscess
Otorrhea
Fissure of Santorini
Subjects
  1. Peter Valentine, Tony Wright. Anatomy and embryology of external and middle ear. In: John C Watkinson and Raymond W Clarke(ed.). Scott-Brown’s otorhinolaryngology and head and neck surgery. Volume2. 8th ed . Boca Raton : CRC Press Taylor and Francies group; 2018. p. 527.
  2. Prasad M, Kraus DH. Acinic cell carcinoma of the parotid gland presenting as an external auditory canal mass. Head Neck 2004;26:85-8.  https://doi. org/10.1002/hed.10347
  3. Urano M, Yoshioka S, Kato H, Horibe K, Hiei Y, Yui T, et al. A case of mucoepidermoid carcinoma of the parotid gland; unusual progression to the external auditory canal via Santorini’s fissures. Japanese Journal of Head and Neck Cancer. 2015 Jan 8;40(4):443-7. https://doi.org/ 5981/ jjhnc. 40.443
  4. Rana K., Rathore P. K., Raj A., Meher R., Wadhwa V., Prakash A, et al. Bilateral spontaneous salivary otorrhoea: case report and a review of the literature.  Int J Pediatr Otorhinolaryngol 2015; 79:1774 –77 http:// dx.doi. org/10. 1016/j. ijporl. 2015. 07. 032
  5. Onal, G. Ovet, N. Alatas. An unusual presentation of parotid abscess: otorrhea. MOJ Surg. 2 (3) (2015) 00023. DOI: 10.15406/mojs. 2015. 02. 00023
  6. Blanco-Sánchez AI, Méndez-Echevarría A, Alonso-Quintela P, García-Perea A, Baquero-Artigao F. Fever, parotid swelling, otorrhea and retroauricular fistula in a child. Enferm Infecc Microbiol Clin. 2017 Jan;35(1):54. https://doi.org/ 10.1016/j. eimc.2015.04.009
  7. Schwarz GA, Blumenkrantz MJ, Sundmäker WL. Neurologic complications of malignant external otitis. Neurology. 1971 Nov;21(11):1077-84. doi: 10.1212/wnl.21.11.1077. PMID: 5001162.
  8. Tornari C, Pal S, Lingam RK, Kalan A. Facial extention of ear pathology: infected cholesteatoma causing a parotid abscess. BMJ Rep 2015; 2015:45.http://dx.doi.org/10.1136/bcr-2014-207550
  9. Franklyn J, Gaikwad P, Lazarus E, Thomas A, Muthusami J. Parotid abscess: A clinical analysis of 40 cases in a tertiary care hospital in India. J Oral Maxillofac Surg Med Pathol 2017 May 1;29(3): 189-92.https://doi.org/10.1016/j.ajoms.2016.10.002

 

  1. .Kim YY, Lee DH, Yoon TM, Lee JK, Lim SC. Parotid abscess at a single institute in Korea. Medicine. 2018 Jul;97(30). doi: 10.1097/ MD. 0000000000011700
  2. Scattergood S, Moore S, Prior A, Yusuf GT, Sidhu PS. Percutaneous drainage of a parotid gland abscess under contrast-enhanced ultrasound guidance: A case report. Ultrasound. 2018 Aug; 26(3):182-6. https://doi.org/10.1177/1742271X18 766705
  3. Dabirmoghaddam P, Mohseni A, Navvabi Z, Sharifi A, Bastaninezhad S, Safaei A. Is ultrasonography-guided drainage a safe and effective alternative to incision and drainage for deep neck space abscesses?. J Laryngol Otol 2017; 131(3): 259-63.  https://doi.org/10.1017/S00222 1511700007X
  4. Tarmizi NE, Rahim SA, Singh AS, Chooi LL, Ong FM, Lum SG. Parotid sialolithiasis and sialadenitis in a 3-year-old child: a case report and review of the literature. Gaz Egypt Paediatr Assoc, 2020 Dec;68(1):1-5.https://doi.org/10.1186/s43054-020-00041-z
Iranian Journal of Otorhinolaryngology
Volume 34, Issue 2
March and April 2022
Pages 135-138