A patient with CSOM presents with post-auricular fistula with pulsatile discharge and brownish granulation tissue. CT temporal bone shows destruction of the posterosuperior wall of the external auditory canal. The most likely complication is:

• A Bezold's abscess
• B Luc's abscess
• C Citelli's abscess
• D Subperiosteal abscess at MacEwen's triangle ✓

Explanation

Subperiosteal abscess forming over the posteromedial aspect of the mastoid — specifically at MacEwen's triangle (the surgical landmark for the mastoid antrum, bounded by the posterior root of the zygoma, suprameatal crest/Henle's spine, and temporalis line) — results from erosion of the outer mastoid cortex by mastoiditis complicating CSOM. It presents as post-auricular swelling, fistula, and displacement of the auricle. Bezold's abscess results from pus tracking through the tip of the mastoid into the digastric groove, presenting in the neck. Citelli's abscess tracks along digastric muscle posteriorly. Luc's abscess is in the external canal floor.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.