Latent mastoiditis: no room for complacency

Martin-Hirsch, D. P.; Habashi, Sherif; Page, Robert E.; Hinton, A. E.

doi:10.1017/s0022215100117268

Cited by 18 publications

(16 citation statements)

References 8 publications

(7 reference statements)

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“…Bezold also reported a third path for mastoid purulence to escape its bony confines, and this involved perforation at the root of the zygomatic process, a phenomenon described even in 1908 as being exceedingly rare. Bezold lectured that in this form of abscess the patient may have pus dissecting under the periosteum of the temporal muscle, similar to the situation between the frontal sinus and frontalis muscle with Pott's puffy tumor 14 …”

Section: Introductionmentioning

confidence: 95%

Contemporary Presentation and Management of a Spectrum of Mastoid Abscesses

et al. 1998

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Since only one third of patients show pathologic tympanic membrane changes, and since complaints of otalgia, fever, and tenderness are inconstant, subperiosteal mastoid abscess is frequently a delayed diagnosis. The clinical presentation, pathogenesis, and routes of abscess spread are presented with photographic and radiographic illustration. Medical and surgical management is reviewed, and methods for accurate diagnosis are emphasized.

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Section: Introductionmentioning

confidence: 95%

Contemporary Presentation and Management of a Spectrum of Mastoid Abscesses

et al. 1998

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“…There are several reports of masked mastoiditis in the literature, most of which describe single intracranial or intratemporal complications [3, 5–8]. In contrast, only one case of masked mastoiditis manifested with multiple intracranial complications has been reported so far [3].…”

Section: Discussionmentioning

confidence: 99%

Pediatric Masked Mastoiditis Associated with Multiple Intracranial Complications

Voudouris

Psarommatis

Nikas

et al. 2015

Case Reports in Otolaryngology

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Masked mastoiditis is a distinct form of mastoiditis with little or no symptomatology, characterized by its potential to generate severe otogenic complications. Therefore, suspected masked mastoiditis should be diagnosed and treated without delay. This study reports a rare case of masked mastoiditis, manifested by multiple intracranial complications in an immunocompetent girl. The child exhibited headache and neurological symptomatology. Imaging studies revealed an epidural and a large cerebellar abscess and the patient was immediately treated with a triple antibiotic therapy. Mastoid surgery and drainage of the epidural abscess took place after the stabilization of the patient's neurologic status, on the 3rd hospitalization day. The cerebellar abscess was treated by craniectomy and ultrasound-guided needle aspiration in the 3rd week of hospitalization. The girl was finally discharged in excellent condition. Two years later, she is still in good health, without otological or neurological sequelae. Masked mastoiditis is an insidious disease which requires increased clinical awareness and adequate imaging. Should clinical and/or radiological findings be positive, mastoidectomy must follow in order to prevent severe otogenic complications that can be triggered by masked mastoiditis.

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“…However, use of broad-spectrum antibiotics may cause suppression of the symptoms and the signs of acute mastoiditis, making the middle ear infection misinterpreted as cured or being in phase of resolution [17] . In these cases, generally known as "masked mastoiditis", early myringotomy is recommended, since intracranial complications such as meningitis or brain abscess may occur [18] . Failure to isolate bacteria is probably due to previous inadequate antimicrobial therapy.…”

Section: Discussionmentioning

confidence: 99%

Acute Mastoiditis in Children as Persisting Problem

Djerić¹,

Folić²,

Blažić³

et al. 2014

Int Adv Otol

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OBJECTIVE: Acute mastoiditis is serious otological condition which may cause difficult, sometimes fatal complications. The aim of the study is to present our experiences in diagnosis and treatment of acute mastoiditis in children. MATERIALS and METHODS:Medical records of 52 children with diagnosis of acute mastoiditis were reviewed retrospectively. Data on clinical presentation, laboratory tests, microbiological and radiological features, prehospital treatment and delay in making the diagnosis, hospital treatment and outcome were analyzed. A relationship between white blood cell count or level of C-reactive protein and therapeutic protocols was investigated. RESULTS:All children were admitted as emergency patients and were treated with intravenous antibiotics. Almost 15% of patients were not examined by a doctor prior to hospitalization. The conservative treatment was successfully conducted in 15% of patients. One-third of the patients were recovered after myringotomy. Almost a half of the patients underwent surgical procedure such as antrotomy, mastoidectomy or tympanomastoidectomy. Computed tomography (CT) scan was done in patients with signs of developing complications and those with no improvement after the beginning of treatment. CONCLUSION:Acute mastoiditis is still persisting problem in our health care system. An early diagnosis and adequate treatment of acute mastoiditis is essential in order to prevent serious complications.

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Latent mastoiditis: no room for complacency

Cited by 18 publications

References 8 publications

Contemporary Presentation and Management of a Spectrum of Mastoid Abscesses

Contemporary Presentation and Management of a Spectrum of Mastoid Abscesses

Pediatric Masked Mastoiditis Associated with Multiple Intracranial Complications

Acute Mastoiditis in Children as Persisting Problem

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