ACUTE MASTOIDITIS

Описание: Acute mastoiditis is a serious complication of untreated otitis media, characterized by infection and inflammation of the mastoid air cells. This condition is significant because it can lead to potentially life-threatening complications, such as Bezold’s abscess, Luc’s abscess, and Citelli’s abscess.

**Pathophysiology**: Acute mastoiditis occurs when the infection spreads from the middle ear into the mastoid bone, leading to the destruction of bony septae and formation of abscesses. Bezold’s abscess forms when the infection erodes through the mastoid tip, extending into the neck's deep tissues. Luc’s abscess, on the other hand, occurs without bony destruction, often manifesting as a subperiosteal abscess. Citelli’s abscess is characterized by the infection tracking into the posterior digastric groove, affecting deeper neck structures.

**Clinical Features**: Common symptoms of acute mastoiditis include ear pain, fever, and swelling behind the ear. Bezold’s abscess presents with neck swelling, pain, and restricted neck movement, indicating deeper infection spread. Luc’s abscess often shows a swelling near the ear without significant pain. Citelli’s abscess can lead to severe pain, tenderness, and sometimes cranial nerve involvement, reflecting its deeper location.

**Diagnosis**: Diagnosis of acute mastoiditis relies on clinical examination and imaging studies. CT scans are crucial in identifying the extent of the disease and any abscess formation. MRI can provide detailed information on soft tissue involvement, particularly in cases of Bezold’s and Citelli’s abscesses.

**Management**: The cornerstone of treatment is prompt antibiotic therapy targeting the common pathogens: Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus. Surgical drainage is often required for abscesses, with procedures ranging from simple incision and drainage to more extensive mastoidectomy, depending on the abscess type and severity.

**Conclusion**: Early recognition and treatment of acute mastoiditis and its complications are vital in preventing severe outcomes. Understanding the distinct features of Bezold’s, Luc’s, and Citelli’s abscesses can aid in accurate diagnosis and management, ensuring better patient outcomes."

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