# A Case Study and Concise Literature Review: Adult Patient’s Initial Manifestation of Complicated Acute Otitis Media Presenting as Jugular Foramen Syndrome

## TL;DR

This case study presents a rare instance where complicated acute otitis media in an adult caused jugular foramen syndrome, emphasizing the need to consider this condition in differential diagnoses.

## Contribution

This is the first documented case of jugular foramen syndrome caused by acute otitis media in an adult.

## Key findings

- A 74-year-old woman presented with neurological symptoms caused by complicated acute otitis media leading to jugular foramen syndrome.
- Imaging confirmed temporal bone inflammation, thrombosis, and jugular vein thrombophlebitis.
- Surgical and medical interventions led to significant postoperative improvement in the patient’s condition.

## Abstract

Background: Jugular foramen syndrome (JFS) is a rare condition characterized by the compression or impairment of one or more terminal cranial nerves passing through the jugular foramen. Although malignancies are the primary cause of JFS. Methods: In this report, we present the first documented case of JFS caused by acute otitis media in an adult patient. Results: A 74-year-old woman presented with ear pain, hoarseness, dysphagia, dizziness, tinnitus, and hearing loss. A physical examination revealed a reddish-bulging tympanic membrane, left-sided hearing loss, right uvula deviation, and cranial nerve palsies affecting the ninth and tenth nerves. Imaging studies confirmed temporal bone inflammation, thrombosis of the sigmoid sinus extending into the internal jugular vein, and signs of thrombophlebitis of the jugular vein. The patient underwent a cortical mastoidectomy, sigmoid sinus decompression, and ventilation tube insertion, along with antibiotic, steroid, and anticoagulant therapy. Postoperatively, the patient’s condition improved significantly. Conclusions: This case highlights the importance of considering complicated acute otitis media in the differential diagnosis of neurological abnormalities associated with JFS. A thorough evaluation of the patient’s medical history and radiological imaging can assist in identifying the cause of the symptoms and guide appropriate surgical or conservative treatment. Further research is essential to gain more comprehensive insights into the pathophysiology and therapeutic interventions of JFS affecting the ears.