Zygomatic abscess as a complication of otitis media

Abstract

Zygomatic abscess is a very rare complication (extra cranial) of acute otitis media. Unfamiliarity with the underlying cause of a swollen cheek can lead to delay of proper treatment with potential harm to the patient. The ideal treatment for these cases is modified radical mastoidectomy with drainage of abscess. We herein present a rare case report of zygomatic abscess associated with otitis media along with its clinical presentation, root of spread and review of its medical and surgical management, with emphasis on the methods for accurate diagnosis. We report on a 55-years-old man who presented with right ear discharge with decreased hearing. High-resolution computed tomography of temporal bone showed irregular osteolytic area involving the posterior portion of the right zygomatic process and zygomatico temporal junction, mastoid air cell, middle ear cavity with erosion of anterior, lateral, and superior wall. There is a evidence of peripherally enhancing collection seen around the right zygomatic process and it measures 3.9*1.6 cm with ill-defined swelling of the soft tissue of right temporal region (masticatory space). Anterior and posterior margin of EAC also shows erosion. The patient underwent a modified radical mastoidectomy with drainage of zygomatic abscess. There was an automastoidectomy and organized granular mass. Zygomatic root abscess is a rare complication of acute otitis media. HRCT scans or magnetic resonance imaging of the temporal bone with wider windows are necessary. Appropriate intravenous ntibiotics and adequate surgeries, as soon as possible, are recommended.