Computed Tomographic versus Surgical Findings in Complicated Acute Otomastoiditis

Computed tomography (CT) plays an important role in planning surgery in cases of complicated middle ear infection. The purpose of this study was to determine, by comparison of radiologic and surgical findings, the diagnostic value of CT in complicated acute otomastoiditis. The study group consisted of 37 patients without a history of chronic ear disease. In this study, CT enabled correct diagnosis of 26 of 27 cases (96%) of subperiosteal abscess, 17 of 18 cases (94%) of mastoid cortex erosion in patients with subperiosteal abscess, and several intracranial complications, including epidural abscess, subdural empyema, and perisinus abscess. The CT scan produced overdiagnosis in some cases: sigmoid sinus thrombosis in 1 patient, mastoid cortex erosion in 2 children with subperiosteal abscess, and bone erosion toward the posterior cranial fossa in 1 patient with meningitis. My findings suggest that subperiosteal abscess is a disease of young children; however, when it develops in an older child, cholesteatoma should be suspected. Furthermore, acute mastoiditis complicated with facial nerve paralysis may be associated with cholesteatoma in 66% of cases. My experience showed that CT had a sensitivity of 97% and a positive predictive value of 94% in the diagnosis of complicated acute otomastoiditis.

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Mastoidectomy for Acute Otomastoiditis: Our Experience

Ear Nose & Throat Journal ◽

10.1177/014556130508400414 ◽

2005 ◽

Vol 84 (4) ◽

pp. 219-222 ◽

Cited By ~ 4

Author(s):

Lela Migirov ◽

Jona Kronenberg

Keyword(s):

Mastoid Cavity ◽

Facial Nerve Paralysis ◽

Nerve Paralysis ◽

Gram Negative ◽

Subperiosteal Abscess ◽

Long Term Follow Up ◽

Intracranial Complications ◽

Gram Negative Organisms

We conducted a retrospective study of 53 mastoidectomies in 51 patients with acute otomastoiditis. In 26 cases (49.1%), surgery had been performed within 48 hours of the development of symptoms. The most common complication of acute otomastoiditis was subperiosteal abscess, which occurred in 37 cases (69.8%). Intracranial complications were seen in 6 cases (11.3%). The most common pathogens isolated from subperiosteal abscesses, the mastoid cavity, and intracranial collections were Streptococcus spp and Staphylococcus aureus. In 14 cases (26.4%), conservative treatment failed to cure acute otomastoiditis; such cases should raise a suspicion of a subperiosteal abscess, an underlying cholesteatoma, or an infection caused by gram-negative bacteria. Upon hospital admission, patients should receive antibiotics that are effective against both gram-positive and gram-negative organisms. Patients with intracranial complications or facial nerve paralysis may require a combination of two or more antibiotics. Long-term follow-up is highly recommended.

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Acute Mastoiditis with Facial Nerve Paralysis in Acute Myeloid Leukemia

Nepalese Journal of ENT Head and Neck Surgery ◽

10.3126/njenthns.v2i2.6796 ◽

2012 ◽

Vol 2 (2) ◽

pp. 13-14

Author(s):

R Acharya ◽

B Tulachan

Keyword(s):

Acute Myeloid Leukemia ◽

Facial Nerve ◽

Head And Neck ◽

Myeloid Leukemia ◽

Neck Surgery ◽

Head And Neck Surgery ◽

Facial Nerve Paralysis ◽

Acute Mastoiditis ◽

Nerve Paralysis ◽

Acute Myeloid

Nepalese Journal of ENT Head and Neck Surgery Vol.2 No.2 Issue 2 (July-Dec 2011) 13-14 DOI: http://dx.doi.org/10.3126/njenthns.v2i2.6796

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Acute mastoiditis in infants aged six months or younger

The Journal of Laryngology & Otology ◽

10.1017/s0022215120001693 ◽

2020 ◽

Vol 134 (8) ◽

pp. 721-726

Author(s):

P Zavras ◽

S Potamianos ◽

M-Z Psarommati ◽

I Psarommatis

Keyword(s):

Retrospective Review ◽

Treatment Options ◽

Age Group ◽

Older Children ◽

Acute Mastoiditis ◽

Drainage Procedure ◽

Algorithmic Approach ◽

Subperiosteal Abscess ◽

Bibliographic Data ◽

Intracranial Complications

AbstractObjectiveBibliographic data for the management of acute mastoiditis in infants aged six months or less are very limited. This study investigated the presenting symptomatology, diagnostic and treatment options, and final outcomes in this age group.MethodA retrospective review was conducted of all infants aged six months or less suffering from acute mastoiditis, admitted to our department between 2007 and 2017.ResultsEleven infants were identified. All of them developed the typical symptomatology of acute mastoiditis, while a higher rate of subperiosteal abscess formation was observed. Imaging was necessary in three cases only. Parenteral antibiotics and myringotomy were applied in all infants. A drainage procedure was also included in the infants with a subperiosteal abscess. Antrotomy was reserved for non-responsive cases. No intracranial complications were observed. All infants were cured without further complications or sequelae.ConclusionAcute mastoiditis in infants aged six months or less can be safely diagnosed and treated using a standardised algorithmic approach, similar to that used for older children.

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The Effective Treatment for Incomplete Recovery after Facial Nerve Paralysis

Korean Journal of Otorhinolaryngology - Head and Neck Surgery ◽

10.3342/kjorl-hns.2013.56.7.397 ◽

2013 ◽

Vol 56 (7) ◽

pp. 397

Author(s):

Jin Kim

Keyword(s):

Facial Nerve ◽

Effective Treatment ◽

Facial Nerve Paralysis ◽

Nerve Paralysis

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Evaluation and management of facial nerve paralysis in MGM medical college

MedPulse International Journal of ENT ◽

10.26611/10161335 ◽

2019 ◽

Vol 13 (3) ◽

pp. 44-48

Author(s):

B K Bhattacharya ◽

◽

Subhajit Sarkar ◽

Keyword(s):

Facial Nerve ◽

Facial Nerve Paralysis ◽

Nerve Paralysis ◽

Medical College

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OSTEOMYELITIS KRONIS MANDIBULA PASCA EKSTRAKSI GIGI DISERTAI BELL’S PALSY

ODONTO Dental Journal ◽

10.30659/odj.6.0.52-55 ◽

2019 ◽

Vol 6 ◽

pp. 52

Author(s):

Yayun Siti Rochmah

Keyword(s):

Facial Nerve ◽

Panoramic Radiograph ◽

Surrounding Tissue ◽

Facial Nerve Paralysis ◽

Muscle Paralysis ◽

Nerve Paralysis ◽

The Right ◽

Spread Of Infection ◽

Nerve System ◽

Intravenous Ketorolac

Background: Chronic osteomyelitis mandibula is one of the complications from dental extraction. Inadequate wound handling can have an impact on the spread of infection in the surrounding tissue like nerve which results in facial nerve paralysis. The purpose is to present a rare case that facilitative nerve paralysis as a result of the spread of osteomyelitis infectionCase Management: A 69 years old woman with chief complains numbness onher lips accompanied by pus out beside the lower teeth. No sistemic disease. Panoramic radiograph showed abnormal bone-like sequester. Extraoral examination appeared the bluish color on the right cheek and there was right facial muscle paralysis. Debridement, sequesterectomy by general anesthesia and medication using ceftriaxone intravenous, ketorolac injection, multivitamin, and corticosteroid, physiotherapy for facial nerve paralyze, also.Discussion: Pathogenesis mandibular osteomyelitis involves contiguous spreadfrom an odontogenic focus infection. The bacteria produce an exotoxin, which, while unable to cross the blood-brain barrier, can have deleterious effects on thePeripheral Nerve System (Fasialis Nerve) in up to 75% of cases, with the severity of presentation correlating with the severity of the infection.Conclusion: Chronic mandibular osteomyelitis can spread the infection to around another anatomy oral cavity like facials nerves.

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Eagle Syndrome Complicated by Posttraumatic Styloid Pseudoarthrosis and Facial Nerve Paralysis

Neurographics ◽

10.3174/ng.2170197 ◽

2017 ◽

Vol 7 (2) ◽

pp. 126-128

Author(s):

R.D. Beegle ◽

I.M. Schmalfuss

Keyword(s):

Facial Nerve ◽

Facial Nerve Paralysis ◽

Nerve Paralysis ◽

Eagle Syndrome

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Idiopathic Facial Nerve Paralysis

The Laryngoscope ◽

10.1288/00005537-199312000-00002 ◽

1993 ◽

Vol 103 (12) ◽

pp. 1326???1333 ◽

Cited By ~ 55

Author(s):

John R. Austin ◽

Steven P. Peskind ◽

Sara G. Austin ◽

Dale H. Rice

Keyword(s):

Facial Nerve ◽

Facial Nerve Paralysis ◽

Nerve Paralysis

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Intracranial Suppurative Complications of Sinusitis

Scandinavian Journal of Surgery ◽

10.1177/1457496915622129 ◽

2016 ◽

Vol 105 (4) ◽

pp. 254-262 ◽

Cited By ~ 9

Author(s):

T. K. Nicoli ◽

M. Oinas ◽

M. Niemelä ◽

A. A. Mäkitie ◽

T. Atula

Keyword(s):

Epidural Abscess ◽

Sinus Thrombosis ◽

Nasal Congestion ◽

Subdural Empyema ◽

University Hospital ◽

Tertiary Referral Hospital ◽

Neck Stiffness ◽

Correct Treatment ◽

Intracranial Infection ◽

Intracranial Complications

Background: Intracranial complications of paranasal sinusitis have become rare due to widespread and early use of antibiotics. Potentially life-threatening intracranial complications of sinusitis include subdural empyema, epidural and intracerebral abscess, meningitis, and sinus thrombosis. Patients with intracranial complication of sinusitis can present without neurological signs, which may delay diagnosis and correct treatment. Aims: Our aim was to evaluate the diagnostics, treatment, and outcome of sinusitis-related intracranial infections at our tertiary referral hospital with a catchment area of 1.9 million people. Materials and Methods: We retrospectively collected data on all patients diagnosed and treated with an intracranial infection at the Helsinki University Hospital, Helsinki, Finland, during a 10-year period between 2003 and 2013. Results: Six patients were diagnosed to have a sinusitis-related intracranial infection. Four patients had an epidural abscess, one both an epidural abscess and a subdural empyema and one a subdural empyema. The most common presenting complaint was headache (100%) followed by fever (83%), vomiting (50%), nasal congestion (50%), forehead lump (34%), and neck stiffness (17%). All patients were managed surgically. Most (83%) patients recovered to premorbid state without neurological sequelae. One patient died intraoperatively. Conclusion: Patients with a sinusitis-related intracranial suppuration typically present with signs of raised intracranial pressure rather than signs of sinusitis. Most are likely to need neurosurgical intervention and evacuation of the abscess without delay.

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