Young male presents with ear discharge since three years; recently patient developed swelling in neck below and behind the angle of mandible, toicollis; on examination external auditory canal was tilled with granulation tissue. What is the diagnosis ?
Correct Answer: Bezold's abscess
Description: Ans. is 'c' i.e., Bezold's abscess Patient has presence of ear discharge since 3 years - thus patient is suffering from chronic suppurative otitis media. Following CSOM patient developed mastoiditis and following mastoidoitis patient has developed abscess behind the angle of mandible and deep to the sternocleidomastoid leading to toicollis. Following are the abscesses related to mastoid infection : 1) Postauricular abscess :- This is the commonest subperiosteal abscess associated with acute mastoiditis. It occurs lateral to the coex of mastoid in MacEwen's triangle 2) Bezold abscess :- Pus passes through mastoid tip and presents as upper neck swelling. The abscess may :- i) Lies deep to sternocleidomastoid ii) Follow the posterior belly of diagastric and presents swelling between mastoid tip and angle of jaw. iii) Be present in posterior triangle iv) Reach the parapharyngeal pouch v) Track down along the carotid vessels. 3) Zygomatic abscess :- Infection of zygomatic air cells. 4) Meatal (Luc's) abscess :- Pus passes between the antrum and external osseous meatus. 5) Citelli's abscess :- Abscess is formed behind the mastoid more towards occipital bone. Some consider it as abscess of diagastric triangle. 6) Parapharyngeal and retropharyngeal abscess.
Category:
ENT
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