Migratory_Ear_Abscess_Case_. Report.pptx

Migratory_Ear_Abscess_Case_. Report

1. Migratory Middle Ear Abscess of Odontogenic Origin A Rare Case Report Summary

2. Patient Information 20-year-old male Pain in right lower second molar for 1 month Facial swelling and limited mouth opening for 6 days Pus discharge intraorally and from right ear for 2 days Difficulty swallowing and mild hearing loss

3. Clinical Findings Right mandibular second molar grossly carious and tender Yellowish pus discharge from right ear with foul odor Right submandibular lymph nodes tender Mouth opening reduced to 11 mm Fever (100°F) and mild systemic symptoms

4. Radiographic and ENT Findings Periapical radiolucency around mandibular right second molar Mild radiolucency near right condylar region Tympanic membrane congested, pus from middle ear Mild hearing loss on right side

5. Treatment Hospital admission and IV antibiotics (3rd gen cephalosporin + sulbactam) NSAIDs administered Extraoral incision and drainage under antibiotic cover Extraction of right lower second molar under local anesthesia Rapid recovery – ear discharge stopped within 24 hours

6. Possible Route of Infection Infection spread from mandibular second molar to pterygomandibular space From there, reached temporomandibular joint (TMJ) Extended via discomallear and Pinto’s ligaments to middle ear Resulted in pus drainage through the ear canal

7. Outcome and Discussion Swelling and limited mouth opening resolved within 5 days Hearing improved considerably First reported case of odontogenic infection discharging through ear Highlights importance of detailed anatomical understanding

8. Conclusion Odontogenic infections can rarely migrate to unexpected sites Physicians must consider unusual spread patterns Any distant pus drainage in head and neck should raise suspicion Proper diagnosis and treatment ensure full recovery