Warnaar A, Snoep G, Stals F S
Department of Otorhinolaryngology, Academic Hospital, Maastricht, The Netherlands.
Int J Pediatr Otorhinolaryngol. 1989 May;17(2):179-83. doi: 10.1016/0165-5876(89)90093-1.
An acute mastoiditis can occasionally present as a swelling in front of the ear. An inflammation of the air cells of the mastoid cavity can spread, via the cells in the root of the zygomatic arch, to the soft tissues of the cheek. Unfamiliarity with this underlying cause of a swollen cheek can lead to delay of proper treatment with potential harm to the patient. This case presents such an uncommon form of mastoiditis in a 3-year-old boy; the failure to recognize the disease initially led to extensive osteomyelitis of the temporal bone. CT scanning was important in establishing the cause of the persistently severe condition of the boy, in spite of bilateral myringotomies and mastoidectomy on the right side. Destruction of bone from the zygomatic arch to the suture between temporal and occipital bone was shown. Extensive removal of diseased bone was achieved neurosurgically, thus leading to uneventful recovery.
急性乳突炎偶尔可表现为耳部前方肿胀。乳突腔气房的炎症可通过颧弓根部的气房蔓延至脸颊的软组织。不熟悉脸颊肿胀的这一潜在病因可能导致延误恰当治疗，对患者造成潜在危害。本病例展示了一名3岁男孩患有的这种罕见形式的乳突炎；最初未能识别该疾病导致了颞骨广泛骨髓炎。尽管对右侧进行了双侧鼓膜切开术和乳突切除术，但CT扫描对于确定该男孩持续严重病情的病因很重要。结果显示从颧弓到颞骨与枕骨之间缝合处的骨质破坏。通过神经外科手术广泛切除了病变骨质，从而实现了顺利康复。
