Acute mastoiditis: The role of imaging for identifying intracranial complications

Luntz, Michał; Bartal, Keren; Brodsky, Alex; Shihada, Rabia

doi:10.1002/lary.22193

Cited by 60 publications

(53 citation statements)

References 25 publications

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“…While acute mastoiditis is usually clinically apparent, the role of CT is important in order to demonstrate other intratemporal or intracranial complications, and to assist in surgical planning [17]. Furthermore, intracranial complications are not always clinically apparent and often detected on CT imaging when there was low clinical suspicion for an intracranial process [18]. In our study population, MRI was reserved for patients with concern for intracranial complications.…”

Section: Discussionmentioning

confidence: 98%

Intratemporal and intracranial complications of acute otitis media in a pediatric population

Mattos

Colman

Casselbrant

et al. 2014

International Journal of Pediatric Otorhinolaryngology

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Section: Discussionmentioning

confidence: 98%

Intratemporal and intracranial complications of acute otitis media in a pediatric population

Mattos

Colman

Casselbrant

et al. 2014

International Journal of Pediatric Otorhinolaryngology

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“…These diagnostic patterns were also seen in prior literature [16] . If an intracranial complication of otitis is suspected, imaging should be performed [25] . Possible underlying otogenic infection should be suspected, ruled out, and treated in all IAs, especially if situated in typical locations of otogenic origin.…”

Section: Discussionmentioning

confidence: 99%

Otogenic Intracranial Abscesses, Our Experience Over the Last Four Decades

Laulajainen‐Hongisto¹,

Aarnisalo

Lempinen³

et al. 2017

Int Adv Otol

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OBJECTIVE:To evaluate the predisposing factors for otogenic intracranial abscesses, assess their changes over time, and analyze how they differ from those due to other causes. MATERIALS and METHODS:The medical records of all patients treated for otogenic intracranial abscesses, between 1970 and 2012 at a tertiary referral center, were retrospectively analyzed. The analysis included patient demographics, clinical characteristics, causative pathogens, treatments, outcomes, and comparisons of otogenic and non-otogenic intracranial abscesses. RESULTS:Of all intracranial abscesses, 11% (n=18) were otogenic. In the 1970s, otogenic infections were a common predisposing factor for intracranial abscess; but within our study period, the incidence of otogenic intracranial abscesses decreased. Most (94%) otogenic cases were due to chronic suppurative otitis media and 78% were associated with cholesteatoma. Most patients (94%) had ear symptoms. The most common presenting symptoms were discharge from the infected ear (50%), headache (39%), neurological symptoms (28%), and fever (17%). The most common pathogens belonged to Streptococcus spp. (33%), Gram-negative enteric bacteria (22%), and Bacteroides spp. (11%). Neurosurgery was performed on all patients, 69% of which were prior to a later ear surgery. Surgery of the affected ear was performed on 14 patients (78%). A favorable recovery was typical (78%); however, one patient died. CONCLUSION:Otogenic intracranial abscesses were most commonly due to a chronic ear infection with cholesteatoma. Ear symptoms and Gram-negative enteric bacteria were more common among patients with otogenic than non-otogenic intracranial abscesses.

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“…While the usefulness of MR imaging in diagnosing intracranial AM spread has been demonstrated many times over, 1,[5][6][7][8][9] intratemporal findings of AM on MR imaging tend to be overlooked and information on their clinical relevance is scarce. Problems exist with overdiagnosing "mastoiditis" on MR imaging if it is based on intramastoid fluid signal alone.…”

mentioning

confidence: 99%

MR Imaging Features of Acute Mastoiditis and Their Clinical Relevance

Saat

Laulajainen‐Hongisto

Mahmood

et al. 2014

AJNR Am J Neuroradiol

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Acute mastoiditis: The role of imaging for identifying intracranial complications

Abstract: It is not possible to define an evidence-based index of suspicion for ICCs in patients with AM. Diagnostic imaging at presentation accordingly remains mandatory.

Cited by 60 publications

References 25 publications

Intratemporal and intracranial complications of acute otitis media in a pediatric population

Intratemporal and intracranial complications of acute otitis media in a pediatric population

Otogenic Intracranial Abscesses, Our Experience Over the Last Four Decades

MR Imaging Features of Acute Mastoiditis and Their Clinical Relevance

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