儿童鼻源性眶壁骨膜下脓肿1例

1临床资料患者,男,10岁,主因左侧牙痛10d,左眼渐进性肿胀凸起8 d,于2021-11-11日入院。10 d前患者无明显诱因出现左侧上列牙齿疼痛,无颌面部肿胀及不适、鼻塞、脓涕症状,自行口服消炎药物(具体不详)后好转。8 d前出现左眼局限性肿胀。

慢性化脓性中耳炎活动期并发耳后骨膜下脓肿的临床分析(附6例报告)

目的分析慢性化脓性中耳炎活动期并发耳后骨膜下脓肿的临床特点和治疗方案。方法回顾性分析2020年8月~2022年4月于青海大学附属医院耳鼻咽喉科就诊的6例耳后骨膜下脓肿患者的致病特点、治疗方式及效果。结果6例均为慢性化脓性中耳炎患者,1例伴有胆脂瘤形成,均表现为耳后红肿及明显疼痛,无全身症状。6例患者的听骨链及外耳道后壁均有不同程度的破坏,5例的手术方式为完壁式乳突根治及鼓室成形,1例中耳胆脂瘤为开放式乳突根治及鼓室成形。1例患者为混合性聋,5例患者为传导性聋。随诊12个月,术后听力较术前改善,预后良好,6例患者均无复发。结论慢性化脓性中耳炎活动期并发的耳后骨膜下脓肿破坏力强,容易出现听骨链、外耳道后壁的破坏,引起明显的听力下降。耳后骨膜下脓肿患者应尽早行脓肿切开,在鼓室成形的同时,应根据是否合并中耳胆脂瘤决定乳突根治为完壁式或开放式。

Sonographic Diagnosis of Acute Hematogenous Osteomyelitis in the Early Stage

This article presents sonographic diagnosis of acute hematogenous osteomyelitis in early stage.24 clildren with clinically suspected acute hematogtnous osteomyelits were detected to have subptrosteal abscesses by ultrasond during four to fourteen days after onset.The mean length and anteroposterior distance of the subperiosteal abscesses were 86.4 mm and 10.7 mm,respectively.Of 24 cases of subperiosteal atscesses,aspiration performed under ultrasound guidance revealed purulent fluid in al and 23 were verified surgically.The results obtained indicate that ultrasound can be used it diagnosis of actue hematogerous osteomyelitis in the early stage.the earliest case was diagrosed by ultrasound 4 days afttr onset.By use of ultrasound, differentiation diagnosis of acute hematogenous osteomyelitis from other diseases such as cellulitis,soff tissue abscess,acutt septic arthritis and maignant bone tumors is also discussed.