Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel.
Acta Paediatr. 2010 Jan;99(1):147-9. doi: 10.1111/j.1651-2227.2009.01533.x.
To present children who underwent mastoidectomy for congenital cholesteatoma presented as a subperiosteal abscess.
All seven children (age range 7-14 years, six boys) presented with retroauricular swelling, erythema and fluctuation in the mastoid area, and one child also had a mastoid-cutaneous fistula. Five children had otorrhoea, while the other two had normal-appearing tympanic membranes. None of the children had a history of middle ear disease. Four children were treated with antibiotics for a recent episode of otitis media prior to admission. The main findings at surgery were pus, granulations and erosion of the mastoid cortex. Pseudomonas aeruginosa and Proteus sp. were isolated from the abscess in two patients, and the other five cultures were negative. All the patients demonstrated some degree of hearing impairment after surgery.
Surgical eradication of a mastoid SA in older children is essential as it may be the first indication of an underlying CC.
介绍以骨膜下脓肿为表现的行乳突切除术的先天性胆脂瘤患儿。
7-14 岁的 7 名儿童（6 名男孩）均表现为耳后肿胀、红斑和乳突区波动，1 名患儿还有乳突-皮肤瘘管。5 名患儿有耳漏，而另外 2 名患儿鼓膜外观正常。患儿均无中耳疾病病史。4 名患儿在入院前因近期中耳炎发作接受了抗生素治疗。手术的主要发现是乳突皮质的脓液、肉芽组织和侵蚀。2 例患者的脓肿中分离出铜绿假单胞菌和变形杆菌，另外 5 例培养结果阴性。所有患儿术后均有不同程度的听力障碍。
对于较大的儿童，必须彻底清除骨膜下脓肿，因为这可能是潜在先天性胆脂瘤的首个指征。
