J Korean Assoc Oral Maxillofac Surg.  2021 Oct;47(5):398-402. 10.5125/jkaoms.2021.47.5.398.

Suppurative mastoid lymphadenitis mimicking mastoiditis: a case report

• Tymofieiev OO
• Ushko NO
• Fesenko II
• Tymofieiev OO
• Yarifa MO
• Cherniak OS

• KMID: 2521798
• DOI: http://doi.org/10.5125/jkaoms.2021.47.5.398

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.

Keyword

Mastoid lymph nodes; Suppurative mastoid lymphadenitis; Abscess; Mastoiditis; Ultrasound

Figure

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  Fig. 1 Right lateral view (A) shows a right suppurative mastoid lymphadenitis (arrows) and left view (B) demonstrates the non-symptomatic side.

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  Fig. 2 The left image (A) shows the patient and symptomatic area from a longitudinal transducer position. Color Doppler sonogram (B) demonstrates soft tissue edema (asterisk) above the mastoid process (curved arrow), a 1.19×0.61-cm reactive upper posterior mastoid lymph node (arrowhead) with a marked hilar vascularity (arrow) and no ultrasound signs of suppuration. The oval shape of the node corresponds to reactive lymphadenitis. Depth of ultrasonography is 3.0 cm.

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  Fig. 3 Image (A) shows the symptomatic area in a longitudinal transducer position. Color Doppler ultrasound image (B) demonstrates a limited collection of pus (the borders are indicated by “+” and “×” calipers) at a place where the lower anterior mastoid lymph node was presumably located. Posterior auricular vessel is indicated by a waved arrow. Depth of ultrasonography is 3.0 cm.

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  Fig. 4 Preoperatively (A) the lesion was noted with painful swelling, erythema, and fluctuation in the right mastoid area (arrow). A mastoid area abscess lancing (B) revealed ~4.0 mL of pus (black arrowheads) (white arrowhead indicates on skin ischemia as a result of local anesthesia) and curettage (C) showed only purulent content with no residual parts of the suppurated mastoid lymph nodes.

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  Fig. 5 Wound view immediately (A) after abscess lancing and on the fourth day (B) of healing by secondary intention.

Reference

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