Inbal Weiss1, Tal Marom, Abraham Goldfarb, Yehudah Roth. 1. Department of Otolaryngology-Head and Neck Surgery, Edith Wolfson Medical Center, Tel-Aviv University Sackler School of Medicine, Holon, Israel.
Abstract
OBJECTIVE: Mastoiditis, subperiosteal abscess and sigmoid vein thrombosis are the most common suppurative complications of acute otitis media (AOM). Luc's abscess, a subperiosteal temporal collection, is an infrequent complication with a particularly benign course. PATIENTS: Two children, aged 5 years, presented with AOM complicated by an atypical abscess deep to the temporalis muscle, with no evidence for mastoid or zygomatic arch involvement. INTERVENTION(S): Computed tomographic scan was performed in only 1 child. In both children, treatment included antibiotic therapy, grommet insertion, and local surgical drainage of the temporalis abscess. In addition, a cortical mastoidectomy was performed in the patient who did not undergo computed tomography, based on clinical assessment. MAIN OUTCOME MEASURE(S): Clinical improvement, resolution of symptoms. RESULTS: Both patients recovered shortly following the surgical drainage. Mastoidectomy was poor in findings and was concluded as redundant. CONCLUSION: Luc's abscess is associated with relatively little morbidity and requires a more limited surgical intervention. Computed tomographic scan is of great value to evaluate the extent of the disease and prevent needless mastoidectomy.
OBJECTIVE:Mastoiditis, subperiosteal abscess and sigmoid vein thrombosis are the most common suppurative complications of acute otitis media (AOM). Luc's abscess, a subperiosteal temporal collection, is an infrequent complication with a particularly benign course. PATIENTS: Two children, aged 5 years, presented with AOM complicated by an atypical abscess deep to the temporalis muscle, with no evidence for mastoid or zygomatic arch involvement. INTERVENTION(S): Computed tomographic scan was performed in only 1 child. In both children, treatment included antibiotic therapy, grommet insertion, and local surgical drainage of the temporalis abscess. In addition, a cortical mastoidectomy was performed in the patient who did not undergo computed tomography, based on clinical assessment. MAIN OUTCOME MEASURE(S): Clinical improvement, resolution of symptoms. RESULTS: Both patients recovered shortly following the surgical drainage. Mastoidectomy was poor in findings and was concluded as redundant. CONCLUSION: Luc's abscess is associated with relatively little morbidity and requires a more limited surgical intervention. Computed tomographic scan is of great value to evaluate the extent of the disease and prevent needless mastoidectomy.