患者牛××,女27岁,农民,因右侧耳前脓肿5天,伴开口困难3天就诊,一年前,患者因右下后牙胀痛不适、轻度开口困难来我科诊治,经检查,诊断为“右下颌智齿冠周炎”,给抗炎治疗,建议炎症消除后拔除智齿,患者未及时复诊,一年间,右下后牙疼痛反复发作,一月前,耳前区皮肤肿胀,伴开口困难,用青霉素80万~μ,Bid,肌注5天,肿胀减轻,近日,牙痛再次发作,耳前肿痛加重。 检查:颌面部双侧不对称,右侧耳前,颞下颌关节区可见一约3×3cm~2脓肿,高出皮肤约1cm,表面皮肤 Patient Niu × ×, female 27 years old, farmer, because of right ear abscess 5 days, with open difficulty 3 days treatment, a year ago, patients with lower right posterior teeth pain, discomfort, mild opening difficulties to our department diagnosis and treatment, After examination, the diagnosis of “right mandibular wisdom teeth pericoronitis” to anti-inflammatory treatment, the proposed removal of wisdom teeth after inflammation, the patient did not promptly referral, one year, right lower back tooth pain recurrent, a month ago, the ear area before the skin Swelling, with open difficulties, with penicillin 800000 ~ μ, Bid, intramuscular injection 5 days, reduce swelling, recently, toothache attack again, aggravating ear pain. Check: maxillofacial bilateral asymmetry, right anterior ear, temporomandibular joint area can be seen about 3 × 3cm ~ 2 abscess, about 1cm above the skin, the surface of the skin