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Intractable Methicillin-Resistant Staphylococcus Aureus Otorrhea with Silicone Impression in the Middle Ear
Eun Kyung Jung1, Chul Ho Jang1, Jong Yuap Seong1
1Department of Otolaryngology, Chonnam National University Medical School, Gwangju, Korea.
Abstract:
We report a case of methicillin-resistant Staphylococcus aureus (MRSA) otorrhea with impression material of hearing aid in the middle ear. The patient had chronic otitis media in the right ear with sensorineural hearing loss in both ears. The silicone flowed into the middle ear through a tympanic membrane perforation during the process of making an ear mold. Several days after hearing aid fitting, the patient had severe otalgia, intractable otorrhea, aggravated hearing loss, and dizziness. The pus culture and sensitivity test revealed MRSA. After topical treatment using diluted vinegar irrigation and ototopical vancomycin solution, intractable otorrhea was controlled. The infected silicone impression was removed by canal wall-up mastoidectomy, and hearing was saved. We present here a review of the literature regarding silicone impression in the middle ear after hearing aid mold fitting.
Insights
A case of methicillin-resistant Staphylococcus aureus (MRSA) otorrhea occurred due to hearing aid silicone migrating into the middle ear. Prompt treatment with antibiotics and surgical removal of the foreign body successfully resolved the infection and preserved hearing.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Biomedical Engineering
Background:
- Chronic otitis media and sensorineural hearing loss are common conditions.
- Hearing aid use is prevalent for managing hearing loss.
- Complications from hearing aid fitting, though rare, require careful consideration.
Purpose of the Study:
- To report a unique case of methicillin-resistant Staphylococcus aureus (MRSA) otorrhea.
- To highlight the potential complication of hearing aid impression material migrating into the middle ear.
- To review the literature on managing foreign bodies in the middle ear from hearing aid fittings.
Main Methods:
- A case study of a patient with chronic otitis media and hearing loss.
- Description of silicone impression material entering the middle ear through a tympanic membrane perforation.
- Documentation of clinical presentation, diagnostic procedures (pus culture), treatment (topical antibiotics, surgery), and outcomes.
Main Results:
- The patient developed severe otalgia, intractable otorrhea, aggravated hearing loss, and dizziness.
- Pus culture confirmed methicillin-resistant Staphylococcus aureus (MRSA) infection.
- Treatment with diluted vinegar irrigation, topical vancomycin, and canal wall-up mastoidectomy successfully controlled infection and preserved hearing.
Conclusions:
- Silicone impression material can migrate into the middle ear, leading to MRSA otorrhea.
- Multifaceted treatment including topical antimicrobials and surgical intervention is crucial.
- Early diagnosis and management are essential for favorable outcomes and hearing preservation in such cases.