A CASE OF NECK ABSCESS PROGRESSING THROUGH THE STERNOCLEIDOMASTOID, NOT THROUGH THE NECK SPACE

Nakayama Jun, Kessoku Hisashi, Takeshita Naohiro, Uchio Norihiko, Shimura Eiji, Hama Takanori, Kojima Hiromi

doi:10.11453/orltokyo.63.2_66

A 42-year-old man presented to our ENT department with a history of persistent lower ear swelling and pain. Contrast-enhanced CT revealed enlargement and central necrosis of the upper deep cervical lymph nodes, and an abscess in the sternocleidomastoid muscle. We started the patient on antibiotic therapy (ampicillin/sulbactam), and punctured the abscess. The next day, we undertook incision and drainage, because the neck findings had become worse. At the time of the operation, we recognized an abscess cavity in the sternocleidomastoid and fistula formation from the abscess to an upper deep cervical lymph node along the accessory nerve. The patient's condition improved after the surgery, and he was discharged on the 23rd hospital day.　Commonly, deep neck infections spread to the adjacent tissues, with potential abscess formation, through nearby cervical spaces intramuscular abscesses are more frequently encountered in the muscles of the lower limbs, and are rare in the cervical region. However, in this case, the infection spread into the muscle along the penetrating blood vessels or nerves.　Based on this case, we wish to highlight the importance of spread of infection via muscles, besides via the cervical spaces, in patients presenting with a deep neck abscess.

A CASE OF NECK ABSCESS PROGRESSING THROUGH THE STERNOCLEIDOMASTOID, NOT THROUGH THE NECK SPACE

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