Uchida Yasue, Ueda Hiromi, Nakashima Tsutomu
Department of Otorhinolaryngology, National Institute for Longevity Sciences, Chubu National Hospital, 36-3 Gengo Morioka, Obu, Aichi 474-8511, Japan.
Auris Nasus Larynx. 2002 Oct;29(4):375-8. doi: 10.1016/s0385-8146(02)00057-3.
The classic Bezold's abscess was described as a deep neck abscess arising from an acute mastoiditis. With the pervasive use of antibiotics, the incidence of otitic suppurative complications including Bezold's abscess has dramatically decreased today. This decreased incidence has led to decreased familiarity and a subsequent increased delay in diagnosis. Otolaryngologists must recognize that intervening in benign processes such as cholesteatoma can lead to unforeseen serious complications. A case of Bezold's abscess arising in a 25-year-old man with recurrent cholesteatoma 20 years after his first surgery is presented. In this patient despite the prior canal wall down tympanoplasty, granulation tissue blocked the pathway from the mastoid to the external auditory meatus. A cholesteatoma formed in this obstructed space became secondarily infected and filled the mastoid cavity with pus. This recent clinical presentation of Bezold's abscess is described and the Japanese literature reviewed to renew familiarity with this rare complication.
经典的贝佐尔德脓肿被描述为一种源于急性乳突炎的颈部深部脓肿。随着抗生素的广泛使用，包括贝佐尔德脓肿在内的耳源性化脓性并发症的发生率如今已大幅下降。这种发生率的降低导致了对其熟悉程度的下降以及随后诊断延迟的增加。耳鼻喉科医生必须认识到，对胆脂瘤等良性病变进行干预可能会导致不可预见的严重并发症。本文介绍了一例25岁男性患者的贝佐尔德脓肿病例，该患者在首次手术后20年患有复发性胆脂瘤。在该患者中，尽管之前进行了开放式鼓室成形术，但肉芽组织阻塞了从乳突到外耳道的通路。在这个阻塞空间中形成的胆脂瘤继发感染，乳突腔内充满了脓液。本文描述了贝佐尔德脓肿的这一最新临床表现，并回顾了日本文献以重新熟悉这种罕见并发症。
