Otogenic Post Auricular Abscess in Adult Patients

Objective: To describe the clinical course ad outcome in a group of adults with an otogenic retro auricular abscess (ORAA).

Method: A retrospective chart review.

Results: Between 2001 and 2015, 7 patients with ORAA - 5 males and 2 females were identified. Their age range was 17 to 62 and 6 of them suffered from chronic otitis media. Five of the patients underwent a previous mastoidectomy (4- canal wall down and 1 had canal wall up) and one of the non-operated patients had cholesteatoma and another patient had chronic suppurative otitis media without cholesteatoma. All patients presented with signs and symptoms of otalgia, swelling and pain around the mastoid. None had any other intratemporal and intracranial complication. All patients underwent a canal wall down (CWD) mastoidectomy with abscess drainage and were treated with parenteral-wide spectrum antibiotics. One patient suffered cardiovascular and respiratory comorbidities, requiring the delay of surgery for 6 days and postsurgical intensive care follow up. This patient underwent incision of the abscess drainage prior to surgery. Pathogens were recognized in 4 of the patients and included Candida Albicans, Streptococcus Pneumonia, Staphylococcus Aureus and Corynebacterium. A minimal 2 year follow up showed well healed mastoids without recurrence of infection and cholesteatoma

Conclusion: OPAA in adults is rare but may be seen in association to neglected chronic otitis media and poor medical follow up. Comorbidities in this older population group are quite probable and may require postponing surgery, so immediate incision and drainage may be warranted.