A CASE OF TEMPORAL MUSCLE ABSCESS
Among cervical abscesses, abscess of the temporal muscle is rare, and its pathological characteristics are still not fully understood. Temporal muscle is one of the masticatory muscles, and pathology involving this muscle can lead to problems with mouth-opening and swelling of the temporal region of...
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| Published in | JIBI INKOKA TEMBO Vol. 63; no. 3; pp. 104 - 108 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Society of Oto-rhino-laryngology Tokyo
15.06.2020
耳鼻咽喉科展望会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0386-9687 1883-6429 |
| DOI | 10.11453/orltokyo.63.3_104 |
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| Abstract | Among cervical abscesses, abscess of the temporal muscle is rare, and its pathological characteristics are still not fully understood. Temporal muscle is one of the masticatory muscles, and pathology involving this muscle can lead to problems with mouth-opening and swelling of the temporal region of the head. The inflammation may also affect the masseter, inner/outer pterygoid muscles, and adjacent gaps in the masticatory muscle gap, and the clinical picture varies depending on the pattern of spread of the inflammation. We encountered a case of temporal muscle abscess that manifested as face pain in a patient with no underlying disease. It is important not only to evaluate the lesion by CT and other imaging modalities, but also to focus on the physical findings, such as mouth-opening disorders and temporal swelling. Spreading downward is typical for neck abscess, but the abscess that we encountered spread upward along the temporal muscle. Our patient improved after incision and drainage of the abscess and antibiotic therapy. |
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| AbstractList | Among cervical abscesses, abscess of the temporal muscle is rare, and its pathological characteristics are still not fully understood. Temporal muscle is one of the masticatory muscles, and pathology involving this muscle can lead to problems with mouth-opening and swelling of the temporal region of the head. The inflammation may also affect the masseter, inner/outer pterygoid muscles, and adjacent gaps in the masticatory muscle gap, and the clinical picture varies depending on the pattern of spread of the inflammation. We encountered a case of temporal muscle abscess that manifested as face pain in a patient with no underlying disease. It is important not only to evaluate the lesion by CT and other imaging modalities, but also to focus on the physical findings, such as mouth-opening disorders and temporal swelling. Spreading downward is typical for neck abscess, but the abscess that we encountered spread upward along the temporal muscle. Our patient improved after incision and drainage of the abscess and antibiotic therapy. Among cervical abscesses, abscess of the temporal muscle is rare, and its pathological characteristics are still not fully understood. Temporal muscle is one of the masticatory muscles, and pathology involving this muscle can lead to problems with mouth-opening and swelling of the temporal region of the head. The inflammation may also affect the masseter, inner/outer pterygoid muscles, and adjacent gaps in the masticatory muscle gap, and the clinical picture varies depending on the pattern of spread of the inflammation. We encountered a case of temporal muscle abscess that manifested as face pain in a patient with no underlying disease. It is important not only to evaluate the lesion by CT and other imaging modalities, but also to focus on the physical findings, such as mouth-opening disorders and temporal swelling. Spreading downward is typical for neck abscess, but the abscess that we encountered spread upward along the temporal muscle. Our patient improved after incision and drainage of the abscess and antibiotic therapy. 側頭筋内膿瘍は頸部膿瘍の中でも文献的報告が少なく, 発症病態の詳細はあまり知られていない。 側頭筋は咀嚼筋に含まれ, 上記疾患の症状として開口障害, 側頭部腫脹を呈する。 炎症は咀嚼筋間隙内の咬筋, 内・外側翼突筋や隣接する間隙にも波及することがあり, その波及形式の相違によっても臨床像は多彩である。 顔面痛を主訴に発症した基礎疾患のない側頭筋内膿瘍を経験した。 本邦での頸部膿瘍形成としては下方への波及が典型的であるが, 今回経験した側頭筋内膿瘍では側頭筋に沿って上方へ波及した膿瘍を形成していた。 CT など画像による病巣評価のみならず, 開口障害, 側頭部腫脹といった身体所見に着目することが本症例の病態把握に重要である。 側頭部穿刺, 経口腔的切開排膿, 抗生剤投与で軽快した1例であった。 |
| Author | Arai, Yuri Yamamoto, Yutaka Kimura, Yuri Takatsu, Namiko Otori, Nobuyoshi Nishiya, Yukio Kojima, Hiromi |
| Author_FL | 西谷 友樹雄 小島 博己 木村 優里 山本 裕 新井 佑梨 高津 南美子 鴻 信義 |
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| Author_xml | – sequence: 1 fullname: Takatsu, Namiko organization: Department of Otorhinolaryngology, The Jikei University School of Medicine – sequence: 1 fullname: Kojima, Hiromi organization: Department of Otorhinolaryngology, The Jikei University School of Medicine – sequence: 1 fullname: Kimura, Yuri organization: Department of Otorhinolaryngology, The Jikei University School of Medicine – sequence: 1 fullname: Nishiya, Yukio organization: Department of Otorhinolaryngology, The Jikei University School of Medicine – sequence: 1 fullname: Otori, Nobuyoshi organization: Department of Otorhinolaryngology, The Jikei University School of Medicine – sequence: 1 fullname: Arai, Yuri organization: Department of Otorhinolaryngology, The Jikei University School of Medicine – sequence: 1 fullname: Yamamoto, Yutaka organization: Department of Otorhinolaryngology, The Jikei University School of Medicine |
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| References | 7) 平木信明: 慢性の経過をたどった咀嚼筋間隙膿瘍症例. 日耳鼻 104: 1143-1146, 2001. 6) 和田匡史, 山本 裕, 高橋 姿: 耳鼻咽喉科領域の痛みの鑑別と治療. 痛みと臨床 6: 367-374, 2006. 15) 西野 宏: 鼻副鼻腔癌の早期発見のコツと pitfall. MB ENT 202: 21-25, 2017. 4) Yonetsu K, Izumi M: Deep facial infections of odontogenic origin: CT assessment of pathways of space involvement. AJNR 19: 123-128, 1998. 13) 河田佐和子: 当科で経験した側頭下窩膿瘍2症例について. 頭頸部外科 18: 119-125, 2008. 14) 斎藤康一郎, 池田哲也: 開口障害, 咬合障害. JOHNS 33: 601-605, 2017. 16) 三輪高喜: 口腔機能異常と中枢疾患. MB ENT 166: 21-26, 2017. 2) 尾尻博也: 咀嚼筋間隙. 耳展 41: 515-516, 1998. 1) 工富公子: 咀嚼筋間隙. 臨床画像 26: 856-868, 2010. 3) Schuknecht B, Stergiou G, Graetz K: Masticator space abscess derived from odontogenic infection: imaging manifestation and pathways of extention depicted by CT and MR in 30 patients. Eur Radiol 18: 1072-1079, 2008. 8) Sields D, Robinson P, Crowley TP: Iliopsoas abscess A review and update on the literature. Int J Surg 10: 466-469, 2012. 10) Gosnell EJ, Anwar B, Varadarajan V, Freeman S: Sernocleodomastoid pyomyositis. Eur Ann Otorhinolarygol Head Neck Dis 133: 273-275, 2016. 5) 泰地秀信: 難治性顔面痛では何を考えるか: 耳鼻咽喉科領域の話題. 医学のあゆみ 229: 453-457, 2009. 12) 川崎泰士, 大久保啓介, 大塚邦憲: 側頭筋に発生した巣状筋炎の1例. 耳展 49: 230-233, 2006. 11) 菅野治重: 嫌気性菌感染症の病原体検査の問題点と将来展望. モダンメディア 53: 307-314, 2007. 9) Crum NF: Bacterial pyomyositis in the United States. Am J Med 117: 420-428, 2004. |
| References_xml | – reference: 7) 平木信明: 慢性の経過をたどった咀嚼筋間隙膿瘍症例. 日耳鼻 104: 1143-1146, 2001. – reference: 4) Yonetsu K, Izumi M: Deep facial infections of odontogenic origin: CT assessment of pathways of space involvement. AJNR 19: 123-128, 1998. – reference: 8) Sields D, Robinson P, Crowley TP: Iliopsoas abscess A review and update on the literature. Int J Surg 10: 466-469, 2012. – reference: 12) 川崎泰士, 大久保啓介, 大塚邦憲: 側頭筋に発生した巣状筋炎の1例. 耳展 49: 230-233, 2006. – reference: 14) 斎藤康一郎, 池田哲也: 開口障害, 咬合障害. JOHNS 33: 601-605, 2017. – reference: 13) 河田佐和子: 当科で経験した側頭下窩膿瘍2症例について. 頭頸部外科 18: 119-125, 2008. – reference: 1) 工富公子: 咀嚼筋間隙. 臨床画像 26: 856-868, 2010. – reference: 6) 和田匡史, 山本 裕, 高橋 姿: 耳鼻咽喉科領域の痛みの鑑別と治療. 痛みと臨床 6: 367-374, 2006. – reference: 2) 尾尻博也: 咀嚼筋間隙. 耳展 41: 515-516, 1998. – reference: 3) Schuknecht B, Stergiou G, Graetz K: Masticator space abscess derived from odontogenic infection: imaging manifestation and pathways of extention depicted by CT and MR in 30 patients. Eur Radiol 18: 1072-1079, 2008. – reference: 9) Crum NF: Bacterial pyomyositis in the United States. Am J Med 117: 420-428, 2004. – reference: 10) Gosnell EJ, Anwar B, Varadarajan V, Freeman S: Sernocleodomastoid pyomyositis. Eur Ann Otorhinolarygol Head Neck Dis 133: 273-275, 2016. – reference: 16) 三輪高喜: 口腔機能異常と中枢疾患. MB ENT 166: 21-26, 2017. – reference: 5) 泰地秀信: 難治性顔面痛では何を考えるか: 耳鼻咽喉科領域の話題. 医学のあゆみ 229: 453-457, 2009. – reference: 11) 菅野治重: 嫌気性菌感染症の病原体検査の問題点と将来展望. モダンメディア 53: 307-314, 2007. – reference: 15) 西野 宏: 鼻副鼻腔癌の早期発見のコツと pitfall. MB ENT 202: 21-25, 2017. |
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| Snippet | Among cervical abscesses, abscess of the temporal muscle is rare, and its pathological characteristics are still not fully understood. Temporal muscle is one... |
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| SubjectTerms | masticatory muscles opening disorder temporal swelling 側頭部腫脹 咀嚼筋 開口障害 |
| Title | A CASE OF TEMPORAL MUSCLE ABSCESS |
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