10 research outputs found
Mastoid Abscess in Acute and Chronic Otitis Media
Background: Mastoid abscess remains a recognised complication of otitis
media despite the advent of antibiotics. The objectives of this study
were to describe the risk factors in patients with mastoid abscess
following acute and chronic otitis media and discuss the management of
this infection. Methods: A retrospective analysis was done on all
patients who underwent mastoidectomy for mastoid abscess from January
2002 to December 2007. Data on the patients’ presentation,
associated complications, management, and follow-up were analysed.
Results: A total of 12 patients were enrolled in this study population.
Group A consisted of patients with mastoid abscess preceded by acute
otitis media, while Group B consisted of patients with mastoid abscess
and chronic otitis media. In Group A (n = 7), 4 patients had a
pre-morbid immunocompromised condition, but they did not have
cholesteatoma. None of the patients in Group B (n = 5) had any
pre-morbid illnesses. Out of 12 patients, 7 patients had associated
extracranial complications, and 1 patient had intracranial
complications. Most patients recovered well after mastoidectomy.
Recurrence was noted in 1 patient who had acute lymphoblastic
leukaemia. Conclusion: Mastoid abscess is still a recognised
complication of acute otitis media, especially in patients who are
immunocompromised. Immunocompetent patients may also develop mastoid
abscess following chronic otitis media associated with cholesteatoma.
Thus, early treatment of otitis media and close vigilant follow-up are
advocated to ensure prompt detection of mastoid abscess complications
The Lower Cheek Flap Combined with Neurosurgical Approach for Infratemporal Fossa Tumour
Acute Tonsillitis With Concurrent Kikuchi’s Disease as a Cause of Persistent Lymphadenopathy
We present a young adult female with symptoms of acute tonsillitis and tender cervical lymphadenopathy. Despite a full course of oral antibiotics, she had persistent left lower cervical lymphadenopathy measuring 2.0 x 1.5 cm at 2 weeks post-treatment. Rigid and flexible scope examinations did not reveal any abnormalities in the nasopharynx, oropharynx or hypopharynx. Tuberculosis tests were negative and blood index results were normal. Fine needle aspiration cytology revealed a non-specific granulomatous inflammatory process. Excisional lymph node biopsy was performed, and the patient was diagnosed as having Kikuchi’s Disease (KD). We would like to highlight the diagnostic challenges in detecting this condition and the importance of differentiating KD from tuberculosis and malignant lymphoma, the latter of which requires aggressive treatment
The Lower Cheek Flap Combined with Neurosurgical Approach for Infratemporal Fossa Tumour
Necrotizing Fasciitis of the Head and Neck: Surgical Outcomes in Three Cases
Necrotizing fasciitis of the head and neck is a rare, rapidly progressive infection involving the skin, subcutaneous tissue and fascia. We report three cases of necrotizing fasciitis that differ in their presentation and outcome. The first case involves a patient who presented with progressively enlarging anterior neck swelling that was later complicated by dehydration and reduced consciousness. The second case is a patient with neck swelling and ipsilateral otorrhea. The third case concerns a patient with a buccal ulcer complicated by ipsilateral facial swelling. All of them underwent a fasciotomy with wound debridement with the addition of a cortical mastoidectomy in the second case. Two of these patients recovered well. Unfortunately, the third case succumbed to death due to airway compromise and septicaemia. We advocate the importance of eradicating the source of infection followed by frequent, meticulous wound dressing and strict blood sugar control to obtain better outcomes in managing necrotizing fasciitis of the head and neck. However, involvement of the airway carries a grave prognosis despite aggressive treatment