PMC6949665_01
Left-sided anterior-inferior tympanic membrane perforation with area of trauma at the entrance to the bony eustachian tube. (a) View with 0-degree endoscope. (b) View with 30-degree endoscope.
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fig1
Physical exam showed a 40% anterior inferior quadrant perforation of the left TM with some swelling around the eustachian tube (Figure 1).
Coronal, axial, and sagittal CTs demonstrating radiopaque foreign body at the level of the bony eustachian tube. (a) Axial CT demonstrating foreign body in the left eustachian tube with normal appearance of the right eustachian tube. (b) Magnified axial CT also demonstrating the proximity to the carotid artery. (c) Coronal CT with object in the left bony eustachian tube. (d) Sagittal CT. (e) Oblique MIP in the same plane as the 3D reconstruction. (f) 3D reconstruction with arrow to the foreign body. (g) Postoperative axial CT. (h) Postoperative coronal CT.
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The CT scan showed a 3 mm metallic object lodged in the left eustachian tube (Figures 2(a)-2(d)). The maximal intensity projection (MIP) and the 3D reconstruction are shown in Figures 2(e) and 2(f). Postoperative CT scans were obtained several months later, showing removal of the object (Figures 2(g) and 2(h)).
Endoscopic view of the foreign body in the eustachian tube. Please see the video online for further surgical views.
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To improve access, a bony tunnel was drilled just lateral to the eustachian tube orifice within the tympanic annular groove (Figure 3).