Department of Otorhinolaryngology, KS Hegde Medical Academy, NITTE (deemed to be University), Mangalore, India.
Department of Paediatrics, KS Hegde Medical Academy, NITTE (deemed to be University), Mangalore, India.
J Int Adv Otol. 2023 Jul;19(4):355-359. doi: 10.5152/iao.2023.22888.
Petrous apicitis and acute bacterial meningitis are uncommon in the present antibiotic era. The diagnosis of petrous apicitis is seldom considered unless there is cranial nerve palsy. A young child with aplasia cutis congenita presented with acute bacterial meningitis and an incidental opacified left mastoid in brain imaging. During the course, fever persisted, and high-resolution temporal bone imaging showed rapid progression to coalescent mastoiditis, petrous apicitis with erosions of tegmen tympani, and petrous apex. Other findings included bony dehiscences and thinning of left calvaria. Tympanomastoid exploration showed herniated brain and cerebrospinal fluid leak through tegmen tympani, which was closed with temporalis fascia graft. Herein, we report a rare presentation of petrous and tegmen erosion along with aplasia cutis congenita and discuss the challenges in diagnosis and management.
在当前抗生素时代，岩尖炎和急性细菌性脑膜炎并不常见。除非存在颅神经麻痹，否则很少会考虑岩尖炎的诊断。一名患有先天性皮肤发育不全的幼儿表现为急性细菌性脑膜炎和脑影像学检查中左侧乳突意外混浊。在此过程中，患儿持续发热，高分辨率颞骨影像学检查显示迅速进展为融合性乳突炎、岩尖炎伴鼓室天盖侵蚀和岩尖。其他发现包括颅骨裂和左侧颅骨变薄。鼓室乳突探查显示脑疝和通过鼓室天盖的脑脊液漏，并用颞肌筋膜移植物关闭。在此，我们报告了一例罕见的岩尖和鼓室天盖侵蚀病例，伴有先天性皮肤发育不全，并讨论了诊断和治疗方面的挑战。
