1
|
D'Arco F, Lee P, Siddiqui A, Nash R, Ugga L. Radiologic diagnosis of non-traumatic paediatric head and neck emergencies. Pediatr Radiol 2023; 53:768-782. [PMID: 36481939 DOI: 10.1007/s00247-022-05556-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/18/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022]
Abstract
Imaging plays a crucial role in evaluating paediatric patients with non-traumatic head and neck lesions in an emergency setting because clinical manifestations of these entities can overlap. For this reason, radiologists must be familiar with the clinical and imaging findings of prevalent paediatric head and neck emergencies. In this review, we present techniques and imaging clues for common complications of pathological processes in the paediatric head and neck, with a focus on the clinical scenario as a starting point for the radiologic approach.
Collapse
Affiliation(s)
- Felice D'Arco
- Department of Radiology, Neuroradiology Unit, Great Ormond Street Hospital, London, UK
| | - Philippa Lee
- Department of Radiology, Imperial College Healthcare NHS Trust, London, UK
| | - Ata Siddiqui
- Radiology Department, Guy's and St. Thomas' NHS Foundation Trust, London, UK
- Department of Neuroradiology, King's College Hospital NHS Foundation Trust, London, UK
| | - Robert Nash
- Ear, Nose and Throat Department, Great Ormond Street Hospital, London, UK
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Sergio Pansini 5, 80131, Naples, Italy.
| |
Collapse
|
2
|
Tymofieiev OO, Ushko NO, Fesenko II, Tymofieiev OO, Yarifa MO, Cherniak OS. Suppurative mastoid lymphadenitis mimicking mastoiditis: a case report. J Korean Assoc Oral Maxillofac Surg 2021; 47:398-402. [PMID: 34713816 PMCID: PMC8564086 DOI: 10.5125/jkaoms.2021.47.5.398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/02/2020] [Accepted: 05/05/2020] [Indexed: 11/17/2022] Open
Abstract
Mastoid lymph node inflammation is a rare entity. Pathological conditions in the vicinity of the mastoid processes can be challenging for maxillofacial head-neck surgeons to address. We report a case of suppurative mastoid lymphadenitis in an 18-year-old Caucasian male. To our knowledge, there are no publications that highlight the clinical, ultrasonographic, intra-, and postoperative data for any pathologic process that presented as mastoiditis.
Collapse
Affiliation(s)
- Oleksii O Tymofieiev
- Department of Maxillofacial Surgery, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
| | - Natalia O Ushko
- Department of Maxillofacial Surgery, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
| | - Ievgen I Fesenko
- Center of Maxillofacial Surgery, Kyiv Regional Clinical Hospital, Kyiv, Ukraine
| | - Olexander O Tymofieiev
- Department of Dentistry, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
| | - Maria O Yarifa
- Department of Oral and Maxillofacial Surgery, Private Higher Educational Establishment "Kyiv Medical University", Kyiv, Ukraine
| | - Olha S Cherniak
- Department of Ultrasound, Regional Diagnostic Center, Kyiv Regional Clinical Hospital, Kyiv, Ukraine
| |
Collapse
|
3
|
Engebretsen S, Patrick T, Helwig C, O'Niel M. Zygomatic air cells in connection with Luc's abscess. Int J Pediatr Otorhinolaryngol 2020; 138:110251. [PMID: 32861976 DOI: 10.1016/j.ijporl.2020.110251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/03/2020] [Accepted: 07/04/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION An uncommon complication of Acute Otitis Media (AOM) is a subperiosteal temporal infection known as Luc's abscess. Zygomatic air cells (ZACs) are an uncommon anatomic variant. CASE SERIES Two otherwise healthy male patients, aged six- and thirteen years-old presented with unilateral otalgia, swelling, trismus, and fever. Imaging revealed Luc's abscess near ZACs. Antibiotics, drainage and myringotomy tubes resulted in a full recovery. CONCLUSION In addition to the spread of soft tissue infection through the Notch of Rivinus, the presence of ZACs may provide a pathway for suppurative effusion and development into Luc's abscess.
Collapse
Affiliation(s)
- Steven Engebretsen
- Children's Hospital of Michigan, Department of Otolaryngology - Head and Neck Surgery, 3901 Beaubien, Detroit, MI, 48201, USA; Michigan State University, 3901 Beaubien, Detroit, MI, 48201, USA.
| | - Tyler Patrick
- Children's Hospital of Michigan, Department of Otolaryngology - Head and Neck Surgery, 3901 Beaubien, Detroit, MI, 48201, USA; Michigan State University, 3901 Beaubien, Detroit, MI, 48201, USA.
| | - Cecelia Helwig
- Children's Hospital of Michigan, Department of Otolaryngology - Head and Neck Surgery, 3901 Beaubien, Detroit, MI, 48201, USA; Wayne State University, 3901 Beaubien, Detroit, MI, 48201, USA.
| | - Mallory O'Niel
- Children's Hospital of Michigan, Department of Otolaryngology - Head and Neck Surgery, 3901 Beaubien, Detroit, MI, 48201, USA; Michigan State University, 3901 Beaubien, Detroit, MI, 48201, USA; Wayne State University, 3901 Beaubien, Detroit, MI, 48201, USA. MO'
| |
Collapse
|
4
|
Luc's Abscess and Temporomandibular Joint Septic Arthritis: Two Rare Sequelae of Acute Otitis Media. Pediatr Emerg Care 2020; 36:e285-e287. [PMID: 29189591 DOI: 10.1097/pec.0000000000001348] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 5-year-old previously healthy child presented with right-sided otalgia, right facial and temporal swelling, and right jaw pain in the setting of 6 days of low-grade fever. The child had no trauma, vomiting, or prior dental treatments. On physical examination, the patient had facial swelling, erythema, and tenderness over the right temporal region along with trismus, as well as pain on palpation of the right temporomandibular joint (TMJ). A computed tomography scan revealed otitis media, Luc's abscess, and TMJ septic arthritis requiring surgical drainage and intravenous antibiotics. The patient responded well to treatment and recovered without sequelae. Dr. Cardwell Luc first described Luc's abscess in 1913 as a rare complication of middle ear infection leading to an abscess in the infratemporal space. To our knowledge, our case is the first documented case of concurrent Luc's abscess and TMJ septic arthritis in a previously healthy child as complications of acute otitis media. This case highlights 2 rare complications of a common medical condition that pediatric emergency care providers should recognize due to the need for surgical intervention, without which there may be longstanding sequelae.
Collapse
|
5
|
Fernandez IJ, Crocetta FM, Pelligra I, Burgio L, Demattè M. Clinical features and management of Luc's abscess: Case report and systematic review of the literature. Auris Nasus Larynx 2019; 47:173-180. [PMID: 31812444 DOI: 10.1016/j.anl.2019.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 11/10/2019] [Accepted: 11/15/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Luc's abscess is a rare complication of acute otitis media, with a challenging diagnosis and a controversial surgical treatment. The aim of the present study was to review the published literature in order to clarify the clinical features and the surgical management of those patients. METHODS A systematic review of the literature was carried out for published reports or case series in English language, describing a temporo-zygomatic (or Luc's) abscess which complicated an acute or chronic otitis media and/or mastoiditis, confirmed through CT scan or MRI of the petrous bone. The collected clinical and radiological data were merged and critically appraised. RESULTS Eighteen reports of Luc's abscess were included. Adding our case report, a total of 21 cases were included in the analysis. Abscess drainage plus myringotomy alone vs. abscess drainage plus myringotomy and mastoidectomy were the two surgical management approaches described in the literature. Patients undergoing first line mastoidectomy were successfully treated in all cases, while among those undergoing a more conservative approach, one failure required subsequent mastoidectomy. CONCLUSIONS The clinical features of Luc's abscess are rather constant and help in rising the suspicion before the radiological diagnosis. Although cases with associated intra-cranic complications have been reported, the limited existing data do not permit to advocate the mastoidectomy over a more conservative surgical approach. However, the decision to avoid mastoidectomy as the first line surgical treatment should be based on the clinical and radiologic assessment, after an accurate counseling, particularly in the case of a pediatric patient.
Collapse
Affiliation(s)
- Ignacio Javier Fernandez
- Otolaryngology Head and Neck Surgery Department, University Hospital of Modena, Via del Pozzo 71, 41100 Modena, Italy.
| | - Francesco Maria Crocetta
- Otolaryngology Head and Neck Surgery Department, University Hospital of Bologna, Via Albertoni 15, 40138 Bologna, Italy
| | - Irene Pelligra
- Otolaryngology Head and Neck Surgery Department, University Hospital of Bologna, Via Albertoni 15, 40138 Bologna, Italy
| | - Luca Burgio
- Otolaryngology Head and Neck Surgery Department, University Hospital of Bologna, Via Albertoni 15, 40138 Bologna, Italy
| | - Marco Demattè
- Otolaryngology Head and Neck Surgery Department, University Hospital of Bologna, Via Albertoni 15, 40138 Bologna, Italy
| |
Collapse
|
6
|
Radiology of acute mastoiditis and its complications: a pictorial review and interpretation checklist. The Journal of Laryngology & Otology 2019; 133:856-861. [PMID: 31475649 DOI: 10.1017/s0022215119001609] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Mastoiditis is an otological emergency, and cross-sectional imaging has a role in the diagnosis of complications and surgical planning. Advances in imaging technology are becoming increasingly sophisticated and, by the same token, the ability to accurately interpret findings is essential. METHODS This paper reviews common and rare complications of mastoiditis using case-led examples. A radiologist-derived systematic checklist is proposed, to assist the ENT surgeon with interpreting cross-sectional imaging in emergency mastoiditis cases when the opinion of a head and neck radiologist may be difficult to obtain. RESULTS A 16-point checklist (the 'mastoid 16') was used on a case-led basis to review the radiological features of both common and rare complications of mastoiditis; this is complemented with imaging examples. CONCLUSION Acute mastoiditis has a range of serious complications that may be amenable to treatment, once diagnosed using appropriate imaging. The proposed checklist provides a systematic approach to identifying complications of mastoiditis.
Collapse
|
7
|
Mengi E, Tümkaya F, Sağtaş E, Ardıç FN. An Unusual Complication of Otitis Media: Luc's Abscess. J Int Adv Otol 2018; 14:497-500. [PMID: 30325335 DOI: 10.5152/iao.2018.4785] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Luc's abscess is an extremely rare complication of otitis media, caused by the spread of the middle ear infection to the subperiosteal area and its accumulation beneath the temporal muscle. Unlike other subperiosteal abscesses relating to otitis media, infection may not be associated with mastoid bone involvement. Therefore, it is defined as a benign complication of otitis media. However, its rare occurrence may lead to delayed diagnosis and treatment. Here we report a case of an 11-year-old boy diagnosed with Luc's abscess with mastoid involvement. We discuss its clinical presentation and treatment with a review of the literature.
Collapse
Affiliation(s)
- Erdem Mengi
- Department of Otolaryngology, Head and Neck Surgery, Pamukkale University School of Medicine, Denizli, Turkey
| | - Funda Tümkaya
- Department of Otolaryngology, Head and Neck Surgery, Pamukkale University School of Medicine, Denizli, Turkey
| | - Ergin Sağtaş
- Department of Radiology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Fazıl Necdet Ardıç
- Department of Otolaryngology, Head and Neck Surgery, Pamukkale University School of Medicine, Denizli, Turkey
| |
Collapse
|
8
|
Luc abscess: an extraordinary complication of acute otitis media. Am J Emerg Med 2016; 34:117.e1-3. [DOI: 10.1016/j.ajem.2015.05.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 05/14/2015] [Indexed: 11/21/2022] Open
|