Bezold's abscess

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Bezold's abscess
Specialty Otorhinolaryngology   OOjs UI icon edit-ltr-progressive.svg

Bezold's abscess is an abscess deep to the sternocleidomastoid muscle where pus from mastoiditis erodes through the cortex of the mastoid part of the temporal bone, medial to the attachment of sternocleidomastoid, extends into the infratemporal fossa, and deep to the investing layer of the deep cervical fascia. It is a rare complication of acute otitis media. [1]

Contents

Symptoms

Symptoms may include:

Diagnosis

CT scan of mastoid and swelling of the neck.

Differential diagnosis should include:

Treatment

Cortical mastoidectomy for mastoiditis. Exploration of fistulous opening into the soft tissues of neck. Drainage of the neck abscess from a separate incision and insertion of a drain. Administration of intravenous antibiotics guided by the culture and sensitivity of the pus.

Eponym

It is named after Friedrich Bezold (German otologist, 1842–1908). [2]

Related Research Articles

Abscess Localized collection of pus that has built up within the tissue of the body

An abscess is a collection of pus that has built up within the tissue of the body. Signs and symptoms of abscesses include redness, pain, warmth, and swelling. The swelling may feel fluid-filled when pressed. The area of redness often extends beyond the swelling. Carbuncles and boils are types of abscess that often involve hair follicles, with carbuncles being larger.

Neck Part of the body on many vertebrates that connects the head with the torso

The neck is the part of the body on many vertebrates that connects the head with the torso and provides the mobility and movements of the head. The structures of the human neck are anatomically grouped into four compartments; vertebral, visceral and two vascular compartments. Within these compartments, the neck houses the cervical vertebrae and cervical part of the spinal cord, upper parts of the respiratory and digestive tracts, endocrine glands, nerves, arteries and veins. Muscles of the neck are described separately from the compartments. They bound the neck triangles.

Lemierres syndrome Medical condition

Lemierre's syndrome refers to infectious thrombophlebitis of the internal jugular vein. It most often develops as a complication of a bacterial sore throat infection in young, otherwise healthy adults. The thrombophlebitis is a serious condition and may lead to further systemic complications such as bacteria in the blood or septic emboli.

Accessory nerve Cranial nerve

The accessory nerve is a cranial nerve that supplies the sternocleidomastoid and trapezius muscles. It is considered as the eleventh of twelve pairs of cranial nerves, or simply cranial nerve XI, as part of it was formerly believed to originate in the brain. The sternocleidomastoid muscle tilts and rotates the head, while the trapezius muscle, connecting to the scapula, acts to shrug the shoulder.

Sternocleidomastoid muscle

The sternocleidomastoid muscle is one of the largest and most superficial cervical muscles. The primary actions of the muscle are rotation of the head to the opposite side and flexion of the neck. The sternocleidomastoid is innervated by the accessory nerve.

Peritonsillar abscess Pus behind the tonsil due to an infection

Peritonsillar abscess (PTA), also known as quinsy, is an accumulation of pus due to an infection behind the tonsil. Symptoms include fever, throat pain, trouble opening the mouth, and a change to the voice. Pain is usually worse on one side. Complications may include blockage of the airway or aspiration pneumonitis.

Mastoiditis Middle ear disease

Mastoiditis is the result of an infection that extends to the air cells of the skull behind the ear. Specifically, it is an inflammation of the mucosal lining of the mastoid antrum and mastoid air cell system inside the mastoid process. The mastoid process is the portion of the temporal bone of the skull that is behind the ear. The mastoid process contains open, air-containing spaces. Mastoiditis is usually caused by untreated acute otitis media and used to be a leading cause of child mortality. With the development of antibiotics, however, mastoiditis has become quite rare in developed countries where surgical treatment is now much less frequent and more conservative, unlike former times.

Common carotid artery One of the two arteries that supply the head and neck with blood

In anatomy, the left and right common carotid arteries (carotids) are arteries that supply the head and neck with oxygenated blood; they divide in the neck to form the external and internal carotid arteries.

Carotid sheath

The carotid sheath is an anatomical term for the fibrous connective tissue that surrounds the vascular compartment of the neck. It is part of the deep cervical fascia of the neck, below the superficial cervical fascia meaning the subcutaneous adipose tissue immediately beneath the skin.

Friedrich Bezold

Friedrich Bezold was a German otologist and professor at the University of Munich. He made several contributions to early audiology.

Pericoronitis Inflammation of the soft tissues surrounding the crown of a partially erupted tooth

Pericoronitis is inflammation of the soft tissues surrounding the crown of a partially erupted tooth, including the gingiva (gums) and the dental follicle. The soft tissue covering a partially erupted tooth is known as an operculum, an area which can be difficult to access with normal oral hygiene methods. The hyponym operculitis technically refers to inflammation of the operculum alone.

Occipital artery

The occipital artery arises from the external carotid artery opposite the facial artery. Its path is below the posterior belly of digastric to the occipital region. This artery supplies blood to the back of the scalp and sternocleidomastoid muscles, and deep muscles in the back and neck.

Mastoid part of the temporal bone

The mastoid part of the temporal bone is the posterior (back) part of the temporal bone, one of the bones of the skull. Its rough surface gives attachment to various muscles and it has openings for blood vessels. From its borders, the mastoid part articulates with two other bones.

Deep cervical fascia

The deep cervical fascia lies under cover of the platysma, and invests the muscles of the neck; it also forms sheaths for the carotid vessels, and for the structures situated in front of the vertebral column. Its attachment to the hyoid bone prevents the formation of a dewlap.

Muscular triangle

The inferior carotid triangle, is bounded, in front, by the median line of the neck from the hyoid bone to the sternum; behind, by the anterior margin of the sternocleidomastoid; above, by the superior belly of the omohyoid.

Cervical lymph nodes

Cervical lymph nodes are lymph nodes found in the neck. Of the 800 lymph nodes in the human body, 300 are in the neck. Cervical lymph nodes are subject to a number of different pathological conditions including tumours, infection and inflammation.

Investing layer of deep cervical fascia

The Investing layer of deep cervical fascia is the most superficial part of the deep cervical fascia, and it encloses the whole neck.

Periodontal abscess Medical condition

A periodontal abscess, is a localized collection of pus within the tissues of the periodontium. It is a type of dental abscess. A periodontal abscess occurs alongside a tooth, and is different from the more common periapical abscess, which represents the spread of infection from a dead tooth. To reflect this, sometimes the term "lateral (periodontal) abscess" is used. In contrast to a periapical abscess, periodontal abscesses are usually associated with a vital (living) tooth. Abscesses of the periodontium are acute bacterial infections classified primarily by location.

Submental space

The submental space is a fascial space of the head and neck. It is a potential space located between the mylohyoid muscle superiorly, the platysma muscle inferiorly, under the chin in the midline. The space coincides with the anatomic region termed the submental triangle, part of the anterior triangle of the neck.

A parapharyngeal abscess is a deep neck space abscess of the parapharyngeal space, which is lateral to the superior pharyngeal constrictor muscle and medial to the masseter muscle. This space is divided by the styloid process into anterior and posterior compartments. The posterior compartment contains the carotid artery, internal jugular vein, and many nerves.

References

  1. Marioni G, de Filippis C, Tregnaghi A, Marchese-Ragona R, Staffieri A (November 2001). "Bezold's abscess in children: case report and review of the literature". Int. J. Pediatr. Otorhinolaryngol. 61 (2): 173–7. doi:10.1016/S0165-5876(01)00564-X. PMID   11589986.
  2. von Bezold, F. (1885). "Ein neuer Weg für die Ausbreitung einer eitrigen Entzündung aus den Räumen des Mittelohrs auf die Nachbarschaft und die in diesem Fall einzuschlagende Therapie". Deutsche Medizinische Wochenschrift. Berlin. 7: 381–5.
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