A child with CSOM and cholesteatoma develops Bezold's abscess. This complication arises from erosion of the:

• A Tip of the mastoid process with pus tracking along the sternocleidomastoid muscle ✓
• B Posterior cortex of the mastoid with pus tracking under the temporalis muscle
• C Tegmen mastoideum with intracranial extension
• D Sigmoid sinus plate with sinus thrombosis

Explanation

Bezold's abscess results from erosion of the inner cortex of the mastoid tip, allowing pus to track inferiorly along the fascial plane of the SCM muscle, presenting as a swelling in the neck below the tip of the mastoid process. This is distinct from Pott's puffy tumour (frontal osteomyelitis) and Citelli's abscess (digastric groove erosion with pus in the posterior triangle). Tegmen erosion causes temporal lobe abscess/meningitis. Sigmoid sinus plate erosion leads to lateral sinus thrombophlebitis.

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.