RESUMO
UNLABELLED: Acute atypical mastoiditis, with temporal and/or facial edema, is called squamozygomatic mastoiditis. There are only a few reports of this occurrence in the literature, which occurs because of an inflammatory process spread to the zygommatic apophysis, when mastoid pneumatization reaches the zygoma or the squamous portion of the temporal bone. Diagnosis is made based on clinical history, physical exam and mastoid CT scan. Treatment is carried out with antibiotic therapy and surgery. AIM: To present a case of squamozygomatic mastoiditis and review the literature. PATIENTS AND METHODS: Report of a case treated in our hospital during the year of 2003 and literature review through the Internet, we also reviewed otolaryngology books from known authors. DISCUSSION: Squamozygomatic mastoiditis is an atypical mastoiditis in which the inflammatory process spreads to the zygomatic apophysis. The infection reaches the temporal bone squamous portion and makes a fistula between this portion and the temporal muscle, shifting the pinna of the ear downwards and it may reach the face, eyes and eyelids. Diagnosis is carried out by clinical history, physical examination and mastoid CT Scan. Treatment is surgical, associated with antibiotic therapy.
Assuntos
Mastoidite/diagnóstico , Infecções Pneumocócicas , Doença Aguda , Feminino , Humanos , Mastoidite/microbiologia , Mastoidite/terapia , Pessoa de Meia-Idade , Infecções Pneumocócicas/microbiologia , Streptococcus pneumoniae/isolamento & purificação , Resultado do TratamentoRESUMO
A mastoidite aguda que se apresenta de forma atípica, com edema temporal e/ou facial, é a chamada mastoidite escamozigomática. Existem poucos relatos sobre essa forma de mastoidite que ocorre devido à propagação do processo inflamatório à raiz da apófise zigomática, quando a pneumatização da mastóide atinge o zigoma ou a porção escamosa do osso temporal. O diagnostico é feito pela história, exame físico e tomografia computadorizada de mastóides. O tratamento é realizado com antibioticoterapia e cirurgia. OBJETIVO: Apresentar um caso de mastoidite escamozigomática e fazer revisão da literatura. PACIENTES E MÉTODOS: Relato de um caso avaliado em nosso hospital no ano de 2003 e revisão da literatura via internet; também foram usados livros de otorrinolaringologia de autores conhecidos. DISCUSSÃO: A mastoidite escamozigomática é uma das formas de apresentação atípica de mastoidite. Ocorre propagação do processo inflamatório até a apófise zigomática. A infecção atinge a escama do osso temporal e fistuliza-se entre esta e o músculo temporal, deslocando o pavilhão auricular para baixo e a podendo atingir face, olhos e pálpebra. O diagnóstico é feito através da historia, exame físico e tomografia computadorizada de mastóides. O tratamento é cirúrgico e associado à antibioticoterapia.
Acute atypical mastoiditis, with temporal and/or facial edema, is called squamozygomatic mastoiditis. There are only a few reports of this occurrence in the literature, which occurs because of an inflammatory process spread to the zygommatic apophysis, when mastoid pneumatization reaches the zygoma or the squamous portion of the temporal bone. Diagnosis is made based on clinical history, physical exam and mastoid CT scan. Treatment is carried out with antibiotic therapy and surgery. AIM: to present a case of squamozygomatic mastoiditis and review the literature. PATIENTS AND METHODS: report of a case treated in our hospital during the year of 2003 and literature review through the Internet, we also reviewed otolaryngology books from known authors. DISCUSSION: squamozygomatic mastoiditis is an atypical mastoiditis in which the inflammatory process spreads to the zygomatic apophysis. The infection reaches the temporal bone squamous portion and makes a fistula between this portion and the temporal muscle, shifting the pinna of the ear downwards and it may reach the face, eyes and eyelids. Diagnosis is carried out by clinical history, physical examination and mastoid CT Scan. Treatment is surgical, associated with antibiotic therapy.