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Acut e atypical mastoiditis, with temporal and/or facial edema, is called squamozygomatic mastoiditis. There are only a few reports of this occurrence in the literature, which occurs because of an inflammatory process spread to the zygommatic apophysis, when mastoid pneumatization reaches the zygoma or the squamous portion of the temporal bone. Diagnosis is made based on clinical history, physical exam and mastoid CT scan. Treatment is carried out with antibiotic therapy and surgery. Aim: to present a case of squamozygomatic mastoiditis and review the literature. Patients and methods: report of a case treated in our hospital during the year of 2003 and literature review through the Internet, we also reviewed otolaryngology books from known authors. Discussion: squamozygomatic mastoiditis is an atypical mastoiditis in which the inflammatory process spreads to the zygomatic apophysis. The infection reaches the temporal bone squamous portion and makes a fistula between this portion and the temporal muscle, shifting the pinna of the ear downwards and it may reach the face, eyes and eyelids. Diagnosis is carried out by clinical history, physical examination and mastoid CT Scan. Treatment is surgical, associated with antibiotic therapy.Keywords: complications of acutes otitis media, mastoiditis, squamozygomatic mastoiditis. Rev Bras Otorrinolaringol 2008;74(4): 617-20. CASE REPORT

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