A Review of the Literature on Luc Abscess
Henri Luc first described lucs abscess, an extracranial complication of acute otitis media, in 1913. This infection manifests itself as a subperiosteal temporal abscess of the external ear canal without mastoiditis or air cell suppuration.
This case report chronicles the case of a 5-year-old boy diagnosed with fever and otorrhea who then experienced left temporal soft tissue swelling. Following surgical drainage and long-term intravenous antibiotic administration, clinical improvement occurred within 3 days.
Early Life and Education
Luc’s abscess, a subperiosteal pus collection beneath the temporal muscle, is a rare complication of acute otitis media that poses unique diagnostic and surgical treatment challenges. To provide greater insight into this condition, this paper reviews existing literature regarding its clinical features in order to illuminate them further.
This 5-year-old boy had fever and otorrhea. A temporal CT scan revealed a left-sided preauricular swelling; with antibiotic therapy and tympanostomy tube placement, his condition significantly improved.
Luc’s abscess stands out among subperiosteal abscesses by its unique spreading pattern: inferiorly through fascial spaces of the sternocleidomastoid to reach the external ear canal wall as a Bezold abscess; or anterior-superior toward mastoid bone and then between it and occipital bone for Citella abscess formation.
Luc abscess is a rare but painful complication of acute otitis media (AOM), manifested as subperiosteal abscess under the temporal muscle. Depending on its location, it may spread subperiosteally into other regions: either inferiorly under the sternocleidomastoid fascia to the forehead and pterygopalatine fossa – bezold abscess; anteriorly over the mastoid process of right mastoid bone – Luc abscess; or towards occipital scalp – Citella abscess.
It is essential to distinguish Luc abscess from other extracranial complications of AOM that involve mastoid bone involvement, as its pathogenesis does not depend on mastoid involvement and therefore conservative treatment with drainage under broad spectrum antibiotics is typically effective. Mastoidectomy should only be considered when clinical signs suggestiveness are observed and radiologic diagnosis verified using high resolution computed tomography of temporal bones.
Luc Abscess is a rare extracranial complication of Otitis Media that typically progresses benignly; this may explain its rarity as opposed to more extracranial complications like Bezold’s and Citelli’s Abscesses1.1
Henri Luc’s 1913 work described a subperiosteal temporal abscess beneath the sternocleidomastoid muscle after acute otitis media (AOM), as one of several extracranial complications of AOM that were not associated with mastoiditis.
This case serves as a clinical reminder that Luc’s abscess can occur even without mastoid involvement, thus necessitating increased suspicion for early diagnosis of this uncommon yet treatable complication of AOM. Early computed tomographic scan of temporal bone scan is of great value in order to avoid unnecessary mastectomy procedures.
Luc’s Abscess (LA) is an uncommon yet often benign complication of acute otitis media (AOM). It appears as a subperiosteal abscess beneath the temporal muscle and usually forms as a subperiosteal abscess beneath its base – unlike most subperiosteal abscesses associated with AOM, LA doesn’t spread directly from middle ear canal to external canal. Furthermore, LA isn’t associated with acute mastoiditis.
This case report describes a patient who developed Luc’s abscess and mastoid involvement that was successfully treated through incision and drainage with broad spectrum antibiotic treatment. CT of the temporal bone proved an effective means for identifying this cohort of patients to help avoid unnecessary mastoidectomy surgeries.