ZYGOMATICITIS (zyromaticitis; [os] of zygomatic [um] a malar + - itis; synonym zygomatitis) — purulent process in cells of a malar shoot of a temporal bone. Arises usually at a complication of acute purulent average otitis, is more often at children, sometimes at an aggravation hron, than average otitis both at children, and at adults. Development of process in a malar shoot is promoted by a delay of exudate in tympanic cavities. Sometimes 3. develops at simultaneous defeat of cellular system in scales of a temporal bone (skvamozigomatitsit). Quite often destructive process in cells of a mastoid passes to an outside wall of a malar shoot of a temporal bone with formation of subperiosteal malar abscess. Isolated 3. develops seldom.
At early children's age can meet so-called false 3., when pus from suppurated periaurikulyarny limf, nodes spreads to the malar area; sometimes false 3. can result from emptying of pus from epidural otogenic abscess through fistula in scales of a temporal bone.
Initial source 3. the disease of an upper wall of outside acoustical pass is. In a malar shoot pus spreads from an antrum and periantralny cells. Pathoanatomical changes in a bone at 3. same, as at mastoiditis (see).
Patients complain of the pains in the field of a malar shoot amplifying during the chewing, a headache, the general weakness, fervescence. Ahead of an auricle and over it there is a painful swelling extending sometimes to area a century. Painful infiltrate at children aged from 1 year up to 3 years appears early — in 2 — 5 days after the beginning of a disease of acute purulent average otitis; at school age — in 10 — 15 days. Occasionally abscess can be emptied outside with burrowing ahead of an auricle. At an otoskopiya the hyperemia and infiltration of a verkhneperedny wall of outside acoustical pass is defined; the tympanic membrane of an infiltrirovan, is surveyed not completely. In blood the leukocytosis, acceleration of ROE is defined.
Recognition 3. it is facilitated by a X-ray analysis of temporal bones according to Schueller, without otvorachivaniye of an auricle of a kpereda. In a picture destruction of cells of mastoidal and malar shoots is visible (see. Middle ear ).
Conservative treatment — the antibiotics warming compresses, Disintoxication therapy. At its unsuccessfulness operation — opening of an antrum, subperiosteal abscess and a root of a malar shoot is shown. If it is opened antrum, then from an upper corner of a wound the section is continued by kpered to a malar shoot and delete a carious bone, as required impose counteropening below a malar shoot.
The forecast is favorable, the intracranial complication in rare instances can develop (meningitis, extradural and subdural abscess of a brain).
Prevention 3. and its complications same, as at a mastoiditis.
Bibliography: The multivolume guide to otorhinolaryngology, under the editorship of A. G. Likhachev, t. 2, M., 1960.
A. R. Hanamirov.