الأربعاء، 19 ديسمبر 2012

A malevolent tooth fairy?


As reported in the BMJ (via Improbable Research):
We are concerned that the actions of the mythical character at the root of this report must be brought to the attention of the medical community, as it seems to represent the first signs of a worrying new trend in malpractice.  Previous anecdotal evidence suggests the tooth fairy is benevolent, but this opinion may need revising in light of mounting reports of less child-friendly activity.

An 8 year old boy was referred to a specialist allergy clinic with a history of profuse mucopurulent rhinorrhoea. After a failure of first line medical treatment, computed tomography of the sinuses was performed. This revealed clear evidence of changes consistent with sinusitis but also a calcified foreign body in the left external auditory meatus (figure).

The family spoke of an occasion three years earlier when the boy had woken from sleep, extremely distressed because the tooth fairy had put a tooth in his left ear. The tooth had initially been left under his pillow for the tooth fairy to collect and to leave some money in its place. Thinking this was a bad dream, the parents initially reassured the boy but were unable to locate the tooth. Nevertheless, his concerns continued, and on two occasions advice was sought from different general practitioners, when the auroscopy was thought to be normal. 

Repeat auroscopy by the allergist confirmed the presence of a deciduous tooth in the auditory canal. The tooth was removed by an ENT surgeon...
[I've added a yellow arrow to the head CT to clarify the position of the tooth].

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