Objectives: To determine the immediate post-operative course
and outcome of pediatric patients with complicated acute mastoiditis
(CAM) following surgical treatment. Study Design: A retrospective chart
review of children diagnosed with CAM who underwent mastoid surgery
during 2012-2019. Setting: Tertiary care university hospital.
Participants: the study includes 33 patients, divided into two groups:
17 patients with subperiosteal abscess (SPA) alone - single complication
group (SCG) and 16 patients with SPA and additional intracranial or
intratemporal complications -multiple complications group (MCG). Main
Outcome Measures: post-operative fever course and pattern (POF). Results
:33 patients belong to the SCG 17(51%) and 16(49%) belonged to the
MCG, respectively. 6/17(35.3%) SCG patients experienced POF vs.
12/16(75%) in the MCG (P=0.012). At post-operative day 2 (POD2),
10/13(77%) febrile patients belonged to MCG and 3/13(23%) to SCG
(P=0.013). POF was recorded until POD6 in both groups. Seven patients,
all from MCG with POF, underwent second imaging with no new findings.
Conclusion: Following a cortical mastoidectomy for CAM, POF is not
unusual in the first 6 days and seem to be benign condition. POF is more
common, higher, and persistent for a longer duration in MCG compared
with SCG. At POD 6, fever is expected to normalize in both groups, so if
fever persists further evaluation should be considered.
Objectives: To evaluate the risk of sensorineural hearing loss (SNHL)
after mastoidectomy in patients with acute mastoiditis (AM) and compare
patients who received surgical versus conservative treatment. Methods: A
retrospective cohort study of medical records of all patients who were
diagnosed with AM at Soroka medical center between the years 2005-2020
and had an available hearing test. Data included demographics, clinical
characteristic, comorbidities, and a pure tune audiometry conducted in
our institution after recovery. Hearing loss (HL) was defined as a
decrease of 15 dB or more in a given frequency. HL was categorized as
mild (25-40 dB decrease), moderate (41-70) or severe (71db<).
Frequencies range was categorized as Low (<500 Hz), middle
(501-2000 HZ) or high (>2001) pitch. We divided the
patients to two groups; patients who received conservative treatment and
patients who underwent surgery. Results: A total of 24 patients met the
inclusion/exclusion criteria, 12 underwent surgery (mean age 20.2 m) and
12 received conservative treatment (mean age 20.1 m). A definite CHL of
10 to 20 dB could be diagnosed in 3 of the 5 patients in each group, who
had bone conduction thresholds measured. SNHL was not observed in any of
the patients old enough to have bone conduction tested Conclusions: This
is the first study to examine HL of children following AM. From our
limited study it seems that the disease itself as well as mastoidectomy
is not a risk factor for developing SNHL later in life.
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