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Bezold's Abscess
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. Symptoms Symptoms may include: * Severe pain in perimastoid region * Difficulty in swallowing (dysphagia) * Sore throat * Difficulty in breathing (dyspnoea) * Nuchal rigidity * Fever Diagnosis CT scan of mastoid and swelling of the neck. Differential diagnosis should include: * Acute upper jugular lymphadenitis * Abscess or mass in Lower part of parotid * Infected branchial cyst * Parapharyngeal abscess * Jugular vein thrombosis 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. Admin ...
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Abscess
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. They are usually caused by a bacterial infection. Often many different types of bacteria are involved in a single infection. In many areas of the world, the most common bacteria present is ''methicillin-resistant Staphylococcus aureus''. Rarely, parasites can cause abscesses; this is more common in the developing world. Diagnosis of a skin abscess is usually made based on what it looks like and is confirmed by cutting it open. Ultrasound imaging may be useful in cases in which the diagnosis is not clear. In abscesses around the anus, computer tomography (CT) may be important to look for deeper infection. Standa ...
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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. Etymology and location It is given the name ''sternocleidomastoid'' because it originates at the manubrium of the sternum (''sterno-'') and the clavicle (''cleido-'') and has an insertion at the mastoid process of the temporal bone of the skull. Structure The sternocleidomastoid muscle originates from two locations: the manubrium of the sternum and the clavicle. It travels obliquely across the side of the neck and inserts at the mastoid process of the temporal bone of the skull by a thin aponeurosis. The sternocleidomastoid is thick and narrow at its centre, and broader and thinner at either end. The sternal head is a round fasciculus, tendinous in front, fleshy behind, arising from the upper part of the front of the manubriu ...
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Mastoiditis
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 (middle ear infection) 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. There is no evidence that the drop in antibiotic prescribing for otitis media has increased the incidence of mastoiditis, raising the possibility that the drop in reported cases is due to a confounding factor such as childhood immunizations against ''Haemophilus'' and ...
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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 (via tendons) and it has openings for blood vessels. From its borders, the mastoid part articulates with two other bones. Etymology The word "mastoid" is derived from the Greek word for "breast", a reference to the shape of this bone. Surfaces Outer surface Its outer surface is rough and gives attachment to the occipitalis and posterior auricular muscles. It is perforated by numerous foramina (holes); for example, the mastoid foramen is situated near the posterior border and transmits a vein to the transverse sinus and a small branch of the occipital artery to the dura mater. The position and size of this foramen are very variable; it is not always present; sometimes it is situated in the occipital bone, or in the suture between the temporal and the occipital. Mastoid process The mastoid process is ...
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Otitis Media
Otitis media is a group of inflammatory diseases of the middle ear. One of the two main types is acute otitis media (AOM), an infection of rapid onset that usually presents with ear pain. In young children this may result in pulling at the ear, increased crying, and poor sleep. Decreased eating and a fever may also be present. The other main type is otitis media with effusion (OME), typically not associated with symptoms, although occasionally a feeling of fullness is described; it is defined as the presence of non-infectious fluid in the middle ear which may persist for weeks or months often after an episode of acute otitis media. Chronic suppurative otitis media (CSOM) is middle ear inflammation that results in a perforated tympanic membrane with discharge from the ear for more than six weeks. It may be a complication of acute otitis media. Pain is rarely present. All three types of otitis media may be associated with hearing loss. If children with hearing loss due to OME do no ...
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Dysphagia
Dysphagia is difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10, in some contexts it is classified as a disease#Terminology, condition in its own right. It may be a sensation that suggests difficulty in the passage of solids or liquids from the mouth to the stomach, a lack of Pharynx, pharyngeal sensation or various other inadequacies of the swallowing mechanism. Dysphagia is distinguished from other symptoms including odynophagia, which is defined as painful swallowing, and Globus Pharyngis, globus, which is the sensation of a lump in the throat. A person can have dysphagia without odynophagia (dysfunction without pain), odynophagia without dysphagia (pain without dysfunction) or both together. A psychogenic disease, psychogenic dysphagia is known as phagophobia. Classification Dysphagia is classified into the following major types: # Oropharyngeal dysphagia # Esophageal dysphagia, Esophageal and obstructive dysphagia # Neuromuscular symptom comp ...
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Sore Throat
Sore throat, also known as throat pain, is pain or irritation of the throat. Usually, causes of sore throat include * viral infections * group A streptococcal infection (GAS) bacterial infection * pharyngitis (inflammation of the throat) * tonsillitis (inflammation of the tonsils), or dehydration, which leads to the throat drying up. The majority of sore throats are caused by a virus, for which antibiotics are not helpful. A strong association between antibiotic misuse and antibiotic resistance has been shown. Symptoms of sore throat include: * a scratchy sensation * pain during swallowing * discomfort while speaking * a burning sensation * swelling in the neck For sore throat caused by bacteria (GAS), treatment with antibiotics may help the person get better faster, reduce the risk that the bacterial infection spreads, prevent retropharyngeal abscesses and quinsy, and reduce the risk of other complications such as rheumatic fever and rheumatic heart disease. In most develop ...
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Dyspnoea
Shortness of breath (SOB), also medically known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity", and recommends evaluating dyspnea by assessing the intensity of its distinct sensations, the degree of distress and discomfort involved, and its burden or impact on the patient's activities of daily living. Distinct sensations include effort/work to breathe, chest tightness or pain, and "air hunger" (the feeling of not enough oxygen). The tripod position is often assumed to be a sign. Dyspnea is a normal symptom of heavy physical exertion but becomes pathological if it occurs in unexpected situations, when resting or during light exertion. In 85% of cases it is due to asthma, pneumonia, cardiac ischemia, interstitial lung disease, congestive heart failure, ...
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Nuchal Rigidity
Neck stiffness, stiff neck and nuchal rigidity are terms often used interchangeably to describe the medical condition when one experiences discomfort or pain when trying to turn, move, or flex the neck. Possible causes include muscle strain or sprain, cervical spine disorders, meningitis, and subarachnoid hemorrhage. Nuchal rigidity due to irritation of the lining of the brain and spinal cord is one of the main symptoms of meningitis. See also * Neck pain Neck pain, also known as cervicalgia, is a common problem, with two-thirds of the population having neck pain at some point in their lives. Neck pain, although felt in the neck, can be caused by numerous other spinal problems. Neck pain may arise ... * Acquired torticollis References Human head and neck {{Med-sign-stub ...
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Fever
Fever, also referred to as pyrexia, is defined as having a body temperature, temperature above the human body temperature, normal range due to an increase in the body's temperature Human body temperature#Fever, set point. There is not a single agreed-upon upper limit for normal temperature with sources using values between in humans. The increase in set point triggers increased muscle tone, muscle contractions and causes a feeling of cold or chills. This results in greater heat production and efforts to conserve heat. When the set point temperature returns to normal, a person feels hot, becomes Flushing (physiology), flushed, and may begin to Perspiration, sweat. Rarely a fever may trigger a febrile seizure, with this being more common in young children. Fevers do not typically go higher than . A fever can be caused by many medical conditions ranging from non-serious to life-threatening. This includes viral infection, viral, bacterial infection, bacterial, and parasitic infect ...
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Friedrich Bezold
Friedrich Bezold (9 February 1842 – 5 October 1908) was a German otologist and professor at the University of Munich. He made several contributions to early audiology. He is best known for developing hearing tests with tuning forks and his work to improve education for the hearing impaired. He was also the first physician to provide a clear understanding of mastoiditis. The following medical terms are named after him: * Bezold's abscess * Bezold's mastoiditis: mastoiditis with perforation into the gigastric groove that creates a deep neck abscess. * Bezold's sign: indication of descending mastoiditis * Bezold's test: method of testing deafness by use of a tuning fork * Bezold's triad: Three symptomatic indications of otosclerosis: 1. diminished aural perception of low frequency tones, 2. retarded bone conduction, 3. negative Rinne test * Bezold-Edelmann continuous scale: A series of tuning forks along with Galton's whistle or monochord, in which all perceptible notes can b ...
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Germany
Germany,, officially the Federal Republic of Germany, is a country in Central Europe. It is the second most populous country in Europe after Russia, and the most populous member state of the European Union. Germany is situated between the Baltic and North seas to the north, and the Alps to the south; it covers an area of , with a population of almost 84 million within its 16 constituent states. Germany borders Denmark to the north, Poland and the Czech Republic to the east, Austria and Switzerland to the south, and France, Luxembourg, Belgium, and the Netherlands to the west. The nation's capital and most populous city is Berlin and its financial centre is Frankfurt; the largest urban area is the Ruhr. Various Germanic tribes have inhabited the northern parts of modern Germany since classical antiquity. A region named Germania was documented before AD 100. In 962, the Kingdom of Germany formed the bulk of the Holy Roman Empire. During the 16th ce ...
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