Head and Neck Abscesses in Complicated Acute Otitis Media-Pathways and Classification

Abstract

Objective: To investigate the pathways of inflammatory spread of extratemporal otogenic complications and present the classification including extratemporal spread of otitis media and mastoiditis. Study design: A retrospective case series at an academic referral center, observational study. Methods: Literature review of rare emergency cases in the course acute otitis media with the development of head and neck abscess. Presentation of different pathways on the lateral and inferior wall of the temporal bone found in computed tomography and during surgery. Results: Inflammatory spread to head and neck following acute otitis media may lead through the mastoid cells (with mastoiditis), external auditory canal, or Eustachian tube. Bezold abscess is the most common extratemporal otogenic neck abscess, but the inflammation may pass through any area of either inferior or lateral wall of the temporal bone, leading to extratemporal complications. Conclusion: Head and neck abscess may complicate the course of AOM and emerges when destruction of lateral or inferior temporal bone surface develops. We can distinguish pathways of inflammatory spread from middle ear to extracranial compartment what should find place in classification of AOM complications.