The most common complication of CSOM that can present as a soft, fluctuant, tender swelling in the posterior ear canal wall ('sagging posterior meatal wall') is:

• A Bezold's abscess
• B Citelli's abscess
• C Zygomaticitis
• D Subperiosteal abscess of the mastoid ✓

Explanation

Subperiosteal (mastoid) abscess forms when pus breaks through the outer cortex of the mastoid process, presenting as a tender, fluctuant post-auricular swelling with the pinna displaced anteroinferiorly and obliteration of the post-auricular sulcus. Bezold's abscess occurs when pus perforates the medial surface of the mastoid tip and tracks down along the sternocleidomastoid or digastric muscle. Citelli's abscess points in the digastric triangle. The sagging posterior meatal wall indicates subperiosteal collection with erosion into the posterior canal.

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.