Bezoldscher Senkungsabszess

Paediatric

acute mastoiditis complicated by Bezold abscess and epidural empyema without bone erosion. Axial contrast-enhanced CT of the head demonstrates filling defect with surrounding enhancement in the left sigmoid sinus and Bezold abscess.

www.eurorad.org • CC by-nc-sa-4.0

Paediatric

acute mastoiditis complicated by Bezold abscess and epidural empyema without bone erosion. Coronal contrast-enhanced CT of the head demonstrates filling defect with surrounding enhancement in the left sigmoid sinus and Bezold abscess.

www.eurorad.org • CC by-nc-sa-4.0

Paediatric

acute mastoiditis complicated by Bezold abscess and epidural empyema without bone erosion. Absent flow void in the left sigmoid sinus with area of high T2 signal lateral to the sinus

www.eurorad.org • CC by-nc-sa-4.0

Paediatric

acute mastoiditis complicated by Bezold abscess and epidural empyema without bone erosion. DWI (b0): Area of restricted diffusion (relative to CSF) lateral to the left sigmoid sinus suggestive of an extra-axial empyema

www.eurorad.org • CC by-nc-sa-4.0

Paediatric

acute mastoiditis complicated by Bezold abscess and epidural empyema without bone erosion. Bezold abscess lateral to the mastoid (arrow) with surrounding enhancement of the sternocleidomastoid muscle. Enhancement around the sigmoid sinus suggestive of thrombosis and/or intracranial collection (asterisk)

www.eurorad.org • CC by-nc-sa-4.0

Paediatric

acute mastoiditis complicated by Bezold abscess and epidural empyema without bone erosion. There is swelling and enhancement of the left sternocleidomastoid muscle (black arrowhead). Note the normal right stenocleidomastoid muscle (white arrow)

www.eurorad.org • CC by-nc-sa-4.0

Toddler with

left earache. Axial CT with contrast of the brain with bone windows (left) shows opacification of the left mastoid air cells and the same image with soft tissue windows (right) shows a low density rim enhancing fluid collection at the level of the left mastoid air cells deep to the sternocleidomastoid and trapezius muscles.The diagnosis was acute mastoiditis with a Bezold abscess.

pediatricimaging.org • CC-by-nc-sa 4.0

Bezold

abscess • Bezold abscess - Ganzer Fall bei Radiopaedia

Rezaee A, Bezold abscess. Case study, Radiopaedia.org (Accessed on 13 Dec 2022) https://doi.org/10.53347/rID-21645 • CC by-nc-sa 3.0 (modified)

Bezold

abscess • Bezold abscess - Ganzer Fall bei Radiopaedia

Jha P, Bezold abscess. Case study, Radiopaedia.org (Accessed on 13 Dec 2022) https://doi.org/10.53347/rID-37981 • CC by-nc-sa 3.0 (modified)

Bezold

abscess • Acute otomastoiditis and Bezold abscess - Ganzer Fall bei Radiopaedia

Marghany B, Acute otomastoiditis and Bezold abscess. Case study, Radiopaedia.org (Accessed on 13 Dec 2022) https://doi.org/10.53347/rID-88184 • CC by-nc-sa 3.0 (modified)

Bezold

abscess • Bezold abscess - Ganzer Fall bei Radiopaedia

Smith D, Bezold abscess. Case study, Radiopaedia.org (Accessed on 13 Dec 2022) https://doi.org/10.53347/rID-98889 • CC by-nc-sa 3.0 (modified)

Radiopaedia • CC-by-nc-sa 3.0 • de

A Bezold abscess is a complication of acute otomastoiditis where the infection erodes through the cortex medial to the attachment of sternocleidomastoid, at the attachment site of the posterior belly of the digastric muscle, and extends into the infratemporal fossa. Due to it being deep to the investing layer of the deep cervical fascia that envelops the sternocleidomastoid muscle and trapezius muscle, it is impalpable.

As the mastoid air cells pneumatize late in childhood, a Bezold abscess is seen usually in the adult population where the cortex is thinner.

Due to the proximity to the internal jugular vein, internal jugular vein thrombosis is a recognized complication.