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Luc's abscess in Down syndrome - A case report
A K Abdul Azim Al-Abrar1, N O Nik Adilah2, M Hazama1
1Universiti Sains Malaysia, School of Medical Sciences, Department of Otorhinolaryngology-Head and Neck Surgery, Health Campus, Kubang Kerian, Kelantan, Malaysia.
The Medical Journal of Malaysia
|September 11, 2021
Summary
Luc's abscess, a rare complication of middle ear infections, can unusually involve the mastoid bone, even in patients with Down syndrome. High-resolution CT scans are crucial for assessing extent and guiding surgical treatment for this extratemporal complication.
Area of Science:
- Otolaryngology
- Pediatric Medicine
- Radiology
Background:
- Luc's abscess is an extratemporal complication of otitis media, typically considered benign due to presumed lack of mastoid involvement.
- This subperiosteal collection under the temporalis muscle is rare and distinct from other otitis-related extratemporal abscesses.
Observation:
- A challenging case of Luc's abscess involving the mastoid bone in a 19-year-old male with Down syndrome is presented.
- High-resolution computed tomography (CT) was essential for delineating the abscess extent, mastoid involvement, and associated complications.
Findings:
- The case highlights that Luc's abscess can, contrary to typical understanding, extend into the mastoid bone.
- Imaging findings guide surgical decision-making, differentiating between conservative and more invasive approaches.
Implications:
- Accurate diagnosis via high-resolution CT is critical for appropriate management of this rare condition.
- While simple drainage is a conservative first step, mastoidectomy may be necessary if the abscess involves the mastoid.
- A 'mastoid-sparing' approach is only viable if conservative treatment achieves complete resolution.
