Intratemporal and Extratemporal Complications in a Rare Case of Acute Mastoiditis: A Case Report and Literature Review

Here, we present a case of a 15-year-old female who presented with an unusual association of intra-temporal (peripheral facial paralysis and petrous apicitis) and extra-temporal (extra-Dural empyema) complications of acute mastoiditis, which was managed with conservative treatment. To our knowledge, this is the first report of such an association. Acute mastoiditis is inflammation and/or infection of the mastoid cavity, which is the most common complication of acute otitis media, although the incidence of complications from otomastoiditis has significantly decreased in the 21st century as a result of the widespread use of antibiotics. Despite this, complications can still be serious and life-threatening. Clinical manifestations are often nonspecific; however, when otological symptoms are present alongside neurological signs, clinicians should suspect complicated otomastoiditis. Computed tomography (CT) of the temporal bone is the gold standard for diagnosis, while MRI is a valuable complement, enhancing diagnostic accuracy and guiding therapeutic decisions. Treatment is mainly conservative, involving empirical antibiotic therapy, whereas surgical procedures should be considered based on individual cases.