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DIAGNOSIS AND MANAGEMENT APPROACH FOR MASTICATOR SPACE MASS IN AN ADULT PRESENTING AS EAR PAIN WITH TRISMUS
DEP. OF OTORHINOLARYNGOLOGY-HEAD AND NECK SURGERY©Ö, AMANG RODRIGUEZ MEMORIAL MEDICAL CENTER, PHILIPPINES, DEP. OF OTORHINOLARYNGOLOGY-HEAD AND NECK SURGERY©÷, CALAMBA MEDICAL CENTER, PHILIPPINES
ALLEN PATRICK D. BUNDOC, ALLEN PATRICK D BUNDOC©Ö, MARGAUX YSABEL B ABAYA©Ö, MARK JANSEN DG AUSTRIA©Ö, RUBILIZA ONOFRE TELAN©Ö ©÷
This is a case of a 46-year-old male having a 2-year recurrent non resolving left ear pain, treated as otitis media, with trismus upon consult at the ED. Head and neck CT scan revealed a fairly demarcated heterogenous mass, 2.9x3.4x2.7 cm, effacing temporalis and deep masseteric muscles superiorly and lateral pterygoid muscle inferiorly, suspicious for malignancy. Incision biopsy via intraoral approach, revealed benign fibromuscular and adipose tissue with mild chronic inflammation, negative for tuberculosis, Gram stain positive, and culture growth of K. Pneumoniae sensitive to Co-Amoxiclav, Ampicillin, Cotrimoxazole, Ertapenem, Imipinem, Meropinem and Piptazobactam. He was started on antibiotic and physical therapy for mastication, referred to Infectious Disease for co-management. Resolution achieved with regained temporomandibular joint motion after 10 days of treatment. Masticator space is a deep fascial component in the infratemporal fossa that contains muscles of mastication. Lesions of various origins affect the area and exhibit similar symptoms namely trismus, facial swelling and referred ear pain. Thus, exercising due diligence in diagnosis and management is significant.


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