Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Int J Oral Maxillofac Surg. 2012 Mar;41(3):380-3. doi: 10.1016/j.ijom.2011.09.011. Epub 2011 Oct 17.
This manuscript reports an uncommon case of inferior third molar facial abscess with purulent secretion drainage through the left external acoustic meatus. The patient's left external acoustic meatus was filled with a purulent secretion observed on a CT scan. He underwent surgery to drain the facial abscess. Despite facial abscesses being routine occurrences, the literature does not contain many case reports of odontogenic facial abscesses with drainage via the external acoustic meatus. These situations occur in two possible ways: multiple fissures in the anterior wall of the cartilaginous portion of the external acoustic meatus; and congenital defects that are occasionally present in the anterior-superior aspect of the external acoustic meatus, known as the foramen of Huschke, which allow communication between the external acoustic meatus and mandibular fossa. These defects may also predispose the patient to the spread of the infection or tumour from the external auditory canal to the infratemporal fossa and vice versa. No otological sequelae were observed in this case. The authors conclude that the hypothesis of bone malformation cannot be excluded, and affirm that any facial abscess requires appropriate and immediate treatment for adequate resolution, by removing the causal factor and providing systemic support.
这篇手稿报告了一个不常见的下颌第三磨牙面部脓肿病例，其脓性分泌物通过左侧外耳道排出。患者的左侧外耳道充满了 CT 扫描观察到的脓性分泌物。他接受了手术以引流面部脓肿。尽管面部脓肿很常见，但文献中很少有牙源性面部脓肿通过外耳道引流的病例报告。这些情况有两种可能的发生方式：软骨部分的外耳道前壁有多个裂隙；以及在外部耳道的前上方偶尔存在的先天性缺陷，称为 Huschke 孔，它允许外耳道和下颌窝之间的连通。这些缺陷也可能使患者容易受到感染或肿瘤从外耳道向颞下窝传播，反之亦然。在这种情况下没有观察到耳科后遗症。作者得出结论，不能排除骨畸形的假设，并肯定任何面部脓肿都需要适当和及时的治疗，以消除病因并提供全身支持，从而充分解决问题。
