Zygomatic Abscess Research Articles

Zygomatic Abscess – A Rare Sequalae of Otitis Media

A zygomatic abscess is a rare complication of acute otitis media. However, over the past two decades, such cases have increased, which might be linked to the rise of antibiotic abuse and antibiotic resistance. Diagnosing and treating a zygomatic abscess is essential as a delay in proper treatment can cause potential harm to the patient. The ideal treatment for these cases is modified radical mastoidectomy with abscess drainage.

A Camouflaged Brain Abscess with Zygomatic Abscess – A Bizzare Presentation in Chronic Suppurative Otitis Media

Intracranial complications of chronic suppurative otitis media (CSOM), even though rare, can have a simultaneous occurrence of multiple complications. An 8-year-old child, a case of CSOM (squamosal) with zygomatic abscess, was referred to us with HRCT temporal bone showing left otomastoiditis and 7 days of higher intravenous antibiotics. The patient was treated with modified radical mastoidectomy and incision and drainage of the abscess. On the 4th postoperative day, he developed focal neurological deficits which confirmed a brain abscess on magnetic resonance imaging on the same side. It was further managed by neurosurgeons. Here, we report this unusual presentation of multiple complications of CSOM.

Complications of chronic suppurative otitis media and their management: five year study at tertiary care centre

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media is a disease that can end up in complications when treatment is delayed. The present prospective study was conducted at our tertiary care hospital and teaching centre to evaluate the incidence of complications of CSOM and their management.</p><p class="abstract"><strong>Methods:</strong> We analysed the clinical and intra operative findings, type of medical and surgical management and recovery of the patient. </p><p class="abstract"><strong>Results:</strong> Total 20 cases of CSOM with complications were reviewed in study period of 5 years. Of these 20 cases, 14 cases had extracranial (EC) while 6 cases had intracranial (IC) complications. The encountered IC complications were brain abscess ie temporal lobe abscess, pyogenic meningitis, lateral sinus thrombophlebitis and extradural abscess. Among the EC complications, mastoid abscess, Bezolds abscess, zygomatic abscess and labyrinthitis were encountered. The IC complications presented with fever, headache, and signs of meningeal irritation. <em>Pseudomonas aeruginosa</em>, <em>Proteus</em>, <em>Staphylococcus epidermidis</em> and <em>E. coli</em> were the common organisms isolated. Both groups of patients had cholesteatoma and middle ear granulations. Surgery was the main modality of treatment with zero mortality rate. We reviewed the clinical presentation and management in both groups.</p><p class="abstract"><strong>Conclusions:</strong> CSOM complications, inspite of their reduced incidence still pose a great challenge in developing countries. When the disease presents late, it lead to difficulty in management and consequently higher mortality. Our study emphasizes the importance of early diagnosis and prompt management.</p>

Zygomatic abscess complicating coalescent air cell infection and acute otitis media in a pediatric patient with facial swelling and temporomandibular joint subluxation

Acute otitis media is a localized infection. Advanced cases demonstrate local spread and abscess formation in the mastoid, temporomandibular joint, and zygomatic root if anatomy allows. We present a case of acute otitis media complicated by an abscess of a pneumatized zygomatic root extending into the temporomandibular joint treated by incision and drainage.

Non accidental injury in disguise; a Paediatric Enigma

Aims: Non accidental injury (NAI) is defined as any abuse inflicted on a person or knowingly not prevented by a care giver. The injury is not consistent with the account of its occurrence. We describe an unusual case that presented with symptoms suggesting immunodeficiency with significant initial diagnostic dilemma. Methods: Clinical data, laboratory and radiological records of our case were reviewed. Results: A 15 month old girl presented with alopecia, recurrent infections comprising left dacryocystitis with subsequent preseptal cellulitis, left maxilla zygomatic abscess and left suppurative otitis media occurring within the preceding 3 months. She also had several episodes of swelling and bruising in various body parts. There was an initial strong suspicion of an underlying immunodeficiency or autoimmune disorder. She was reviewed extensively by multiple disciplines with a battery of blood investigations which was not in keeping with either. Chest radiograph was normal but surprisingly revealed fractures of both proximal humeral metaphyses beyond the field of focus. Further radiological investigations including skeletal surveys showed multiple healing fractures without evident osteopenia. These events in retrospect were closely linked to the period of care by a close care giver. She made an excellent recovery evident on 5 months follow up. She is well known to child protection services. Conclusion: The diagnosis of NAI is complex; this will ultimately depend upon evidence collected from all agencies involved in the care of the child. The thorough investigation of children with suspected NAI is critical to assure their safety.

Zygomatic Abscess with Temporomandibular Joint Effusion Complicating Acute Otitis Media

Zygomatic Abscess with Temporomandibular Joint Effusion Complicating Acute Otitis Media

Zygomatic abscess as a complication of otitis media

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.

Extracranial complications of chronic suppurative otitis media

The aim of this study was to find out the pattern of extracranial complications of CSOM cases who attended to the department of ENTD, Mymensingh Medical College Hospital during the period from July'1999 to June' 2001. Different types of extracranial complications of CSOM were presented here. A total of 100 cases, diagnosed clinically and radiologically were included in the study of which 66 were male and 34 were female giving a male to female ratio of 1.94 : 1 (p < 0.05). Majority cases (53) were in the age group of 11- 20 years followed by the age group of below 10 years where there were 30 cases. Majority (64) cases came from low socio-economic class. The number of different types of extracranial complications of CSOM were as follows: mastoid abscess 57, discharging sinuses 28, purulent labyrinthitis 07, Bezold's abscess 04, fascial nerve paralysis 03 and zygomatic abscess 01. In all cases of CSOM Cholesteatoma were detected. In 14 cases, Cholesteatoma were associated with granulation tissue/polyp. Modified radical mastoidectomy were performed in all cases. On analyzing the findings of the present study it was observed that mastoid abscess were the predominant extracranial complications of CSOM, affecting mostly the male population of 11 - 20 years age group coming from low socio-economic class.

Zygomatic abscess with temporal myositis — a rare extracranial complication of acute otitis media

Acute mastoiditis is the most common complication of acute otitis media (AOM) and its early recognition and management still poses a challenge due to potentially serious consequences. The incidences of extracranial and intracranial suppurative complications of AOM in children have decreased significantly, yet they remain a serious clinical problem, especially when caused by bacteria resistant to antibiotics. The authors presented a case of rare AOM complication - zygomatic abscess with temporal myositis. A 6-year-old boy was admitted to the ENT Department with 4 weeks of ear pain, treated for AOM with cefuroxime axetyl and amoxicilline, with acute mastoiditis and subsequent abscess formation in zygomatic and preauricular region. The inflammatory process spread through anterior air cells to the zygomatic cells leading to a fistula formation in the zygomatic bone and breakthrough into the temporal muscle. The surgical procedures applied were: myringotomy with drainage, cortical mastoidectomy and revision of zygomatic area and treatment with antibiotics (ceftriaxon). Enterococcus faecalis and Streptococcus viridans were found in the culture of middle ear and mastoid effusion. After half a year of follow-up the child had a normal hearing. Severe complications of AOM are rare today. An early diagnosis in order to promote adequate management and prevent inherently suppurative complications is essential.

Temporal and Zygomatic Abscess in Chronic Middle-Ear Suppuration

Temporal and Zygomatic Abscess in Chronic Middle-Ear Suppuration