Babin E, Brenac F, Bequignon A, Goullet De Rugy M, Edy E, Moreau S, Valdazo A
Service ORL et de Chirurgie Cervico-Faciale, CHU, Avenue de la côte de nacre, 14033 Caen Cedex.
Ann Otolaryngol Chir Cervicofac. 2001 Oct;118(5):323-9.
We report a case of extradural abscess after acute mastoiditis in an 8-years-old boy. The clinic diagnostic of an intracranial complication is difficult. The most common present symptoms are fever, otalgia and otorrhea but are not specific. Neurologic symptoms are suggestive signs of an intracranial complication. We believe that, in acute mastoiditis performance of a CT scan of the brain and temporal bones with intravenous contrast, contribues to the diagnostic of intracranial complication. The diagnostic of thrombosis sinus sigmoid is evoked with slight contrast enhanced sinus sigmoid and failure to opacify. The characterisation of an epidural empyema is a hypodense epidural collection in a contrast-enhanced CT scan. The most common isolated organism are Streptococcus Pneumoniae, Staphylococcus aureus and Pseudomonas aeuginosa. The therapeutic management includes combination of intraveinous antibiotics, mastoidectomy and surgery of the intracranial complication.
我们报告一例8岁男孩急性乳突炎后发生硬膜外脓肿的病例。颅内并发症的临床诊断较为困难。最常见的当前症状是发热、耳痛和耳漏,但这些症状并不具有特异性。神经系统症状是颅内并发症的提示性体征。我们认为,对于急性乳突炎患者,进行静脉注射造影剂的脑部和颞骨CT扫描有助于诊断颅内并发症。乙状窦血栓形成的诊断可通过乙状窦轻微强化且未显影来提示。硬膜外脓肿在增强CT扫描中的特征是硬膜外低密度积液。最常见的分离出的病原体是肺炎链球菌、金黄色葡萄球菌和铜绿假单胞菌。治疗管理包括静脉使用抗生素、乳突切除术以及对颅内并发症进行手术。