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Acta Bio-medica : Atenei Parmensis Feb 2020Acute mastoiditis is the most common complication of acute otitis media. Although rare, the disease is carefully studied by otolaryngologists because it usually affects... (Review)
Review
Acute mastoiditis is the most common complication of acute otitis media. Although rare, the disease is carefully studied by otolaryngologists because it usually affects very young children with severe clinical course and sometimes causes serious complications. Most important risk factors are the young age (often>2 years), high fever, alteration of the laboratory findings (very high values of WBC count, absolute neutrophil count and C-reactive protein), while less important are previous antibiotic therapy or previous middle ear infections. The main pathogen of the acute mastoiditis is Streptococcus pneumoniae, followed by Streptococcus piogenes, Haemophilus influentiae, and Staphylococcus aureus. The finding of Pseudomonas aeruginosa is not uncommon, but often its presence is often considered a contamination or simultaneous infection. The complications can be extracranial (subperiosteal abscess, Bezold's abscess); intratemporal (facial nerve palsy, labyrinthitis) and intracranial (subdural abscess). The complications have often a very serious clinical course and potentially life-threatening. Antibiotic therapy is the main treatment in not complicated forms. Considering the prevalence of Streptococcus pneumoniae, cephalosporins are the antibiotic of choice, but they have to be administrated intravenously in hospitalized patients. Combinations with other antibiotic are suggested when multibacterial flora is present. In complicated forms of acute mastoiditis, the antibiotic treatment can be particularly important, in combination with other specific drugs (i.e. anticoagulants and/or corticosteroids). Surgical treatments, such as incision of abscesses, mastoidectomy, and neurosurgical procedures, are sometimes performed in combination with medical therapy in very severe complications. Data from our experience are briefly reported.
Topics: Acute Disease; Anti-Bacterial Agents; Child; Humans; Mastoiditis
PubMed: 32073562
DOI: 10.23750/abm.v91i1-S.9259 -
Ear, Nose, & Throat Journal May 2022We report a case of primary temporal bone diffuse B-cell non-Hodgkin lymphoma, which is a rare entity. A 71-year-old male with a history of dementia and hemicraniectomy...
We report a case of primary temporal bone diffuse B-cell non-Hodgkin lymphoma, which is a rare entity. A 71-year-old male with a history of dementia and hemicraniectomy presented due to 1 month of a pronounced left ulcerative mastoid lesion. Strikingly, there were no cranial nerve deficits which was unexpected due to the degree of the lesion. Initially, infectious mastoiditis was suspected based on physical examination alone. Due to the patient being a poor historian, it was difficult to determine whether this was an acute or chronic issue. Temporal bone squamous cell carcinoma, infectious mastoiditis, and actinomycosis were on the differential, but biopsies revealed non-Hodgkin lymphoma.
Topics: Actinomycosis; Aged; Diagnosis, Differential; Humans; Lymphoma, Non-Hodgkin; Male; Mastoid; Mastoiditis; Temporal Bone
PubMed: 32841094
DOI: 10.1177/0145561320950493 -
The Journal of International Advanced... Jul 2022Congenital cholesteatomas account for just up to 5% of all cholesteatomas and most commonly arise in the petrous apex and middle ear. Congenital cholesteatomas arising...
BACKGROUND
Congenital cholesteatomas account for just up to 5% of all cholesteatomas and most commonly arise in the petrous apex and middle ear. Congenital cholesteatomas arising in the mastoid are rare and typically present late.
METHODS
In this study, we report a case series of 3 cases managed in our department between 2006 and 2021 and present a summary of the current literature.
RESULTS
Congenital cholesteatomas arising in the mastoid is a rare finding and even among reported cases, not all are clearly mastoid in origin. Their location allows for considerable growth before symptoms develop. Pain and localized swelling in the temporal area are the most common presenting symptoms which can lead to diagnostic challenges. Our cases show that although surgery is often appropriate, conservative manage- ment may be suitable in certain situations.
CONCLUSION
Congenital cholesteatoma of mastoid origin is rare and can present a diagnostic challenge. Greater awareness is important to facilitate early detection. A high index of suspicion is needed in those presenting with retro-auricular pain and swelling in the context of a normal ontological examination.
Topics: Bone Diseases; Cholesteatoma; Cholesteatoma, Middle Ear; Ear, Middle; Earache; Humans; Mastoid
PubMed: 35072629
DOI: 10.5152/iao.2022.21450 -
The Journal of Craniofacial Surgery Sep 2020All around world, the COVID-19 pandemic is accelerating, and any insight we can learn from our colleagues who have either encountered or are currently going through this... (Review)
Review
All around world, the COVID-19 pandemic is accelerating, and any insight we can learn from our colleagues who have either encountered or are currently going through this will be used to protect our patients, our medical staff, and ourselves. No one knows to the best of our understanding whether or not COVID-19 includes the respiratory mucosal lining the middle ear and mastoid air cell system-but it seems probable they do. Since the rest of the airways are affected, and so is the nose and nasopharynx, it seems possible that the lining of the Eustachian tube, middle ear and mastoid air cell system would all be polluted. Viral particle aerosolization, which can occur otologic surgery using powered instruments and they remain in the air for at least 3 hours. Powered air purifying respirators are supplied even shorter than N95 masks, but strongly believed they are important for our team safety and protection. This mini review provides fundamental knowledge on otologic surgery feasibility in the COVID-19 pandemic from an objective perspective.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Masks; Otologic Surgical Procedures; Pandemics; Pneumonia, Viral; Respiratory System; SARS-CoV-2
PubMed: 32472898
DOI: 10.1097/SCS.0000000000006694