Management of acute complicated mastoiditis at an urban, tertiary care pediatric hospital

Ghadersohi, Saied; Young, Nancy M.; Smith-Bronstein, Virginia; Hoff, Stephen R.; Billings, Kathleen R.

doi:10.1002/lary.26365

Cited by 31 publications

(12 citation statements)

References 17 publications

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“…In a recent review by Ghadersohi et al examining the management of 48 pediatric patients with acute mastoiditis at a tertiary pediatric hospital, myringotomy with tympanostomy tube insertion was used in 95% of cases as part of therapy. 41 In this study, 81.8% of patients who had presence of a subperiosteal abscess underwent incision and drainage of the abscess, and 18.1% of these underwent cortical mastoidectomy. Cortical mastoidectomy is indicated in acute coalescent mastoiditis.…”

Section: Microbiology and Treatmentmentioning

confidence: 73%

Acute Otologic Infections in Pediatric Patients

Tipton

Honsinger

Harris

et al. 2018

J Pediatr Infect Dis

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This article summarizes significant acute infections involving the pediatric temporal bone. First, the management of acute otitis media (AOM) is discussed, including the medical and surgical management of invasive intracranial and extracranial complications associated with advanced disease. The clinical and radiographic findings, microbiology, and management of acute mastoiditis are discussed in greater detail, followed by the presentation and treatment of acute otitis externa (AOE). Finally, we discuss infectious considerations in auditory implants. The indications and use of both cochlear implants (CI) and bone conduction hearing implants have rapidly expanded in children, requiring greater understanding of managing infections in the context of these devices.

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Section: Microbiology and Treatmentmentioning

confidence: 73%

Acute Otologic Infections in Pediatric Patients

Tipton

Honsinger

Harris

et al. 2018

J Pediatr Infect Dis

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“…The surgical management may differ between various medical centers and include myringotomy, placement of VT, and incision plus drainage of SPA, with or without cortical mastoidectomy. Patients presenting intracranial complications are most likely to undergo a mastoidectomy (8) . In a series of 570 children published recently from Israel, reported a significant increase in AM cases that had an indication for surgical intervention during the years 2008-2017 (11% vs. 19% between the first and the last five years of the study respectively, P = 0.008) and described higher fever, leukocytes counts and CRP values in CAM compared to simple AM (9) .…”

Section: Discussionmentioning

confidence: 99%

The clinical course of children undergoing mastoidectomy due to complicated mastoiditis

Ziv

Sapir

Leibowitz

et al. 2021

Preprint

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Objectives: To determine the immediate post-operative course and outcome of pediatric patients with complicated acute mastoiditis (CAM) undergoing simple mastoidectomy. Study Design: A retrospective chart review of children diagnosed with CAM who underwent a mastoidectomy during 2012-2019. Setting: Tertiary care university hospital. Participants: 33 patients were divided into two groups: 17 patients with subperiosteal abscess (SPA) alone- single complication group (SCG) and 16 patients with SPA and additional complications (sigmoid sinus vein thrombosis, perisinus fluid/abscess, epidural abscess)-multiple complications group (MCG). Main Outcome Measures: post-operative data were collected. Demographics, microbiology data, inflammatory parameters, hospitalization length, and POF pattern were recorded, compared, and analyzed. Results: Of 162 acute mastoiditis patients, 33(20.4%) underwent surgery due to CAM; 17(51%) and 16(49%) belonged to the SCG and 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; A total of 18 positive cultures were reported. Fusobacterium necrophorum counted for 8/18(44.5%) of all positive cultures, 7/9(77.8%) in the MCG vs. 1/9(11.1 %) in the SCG, P=0.004. Streptococcus pneumoniae was reported only in SCG (5/9, 55.5%, vs. 0/9, P=0.008). Conclusion: Post-mastoidectomy fever due to CAM is not unusual and seems to be a benign condition for the first 5-6 days following surgery. MCG patients are more prone to develop POF. F. necrophorum is more likely to be associated with MCG, and S. pneumoniae is common in SCG patients. Keywords: Mastoiditis, post-operative fever, complications, microbiology

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“…La mayoría de pacientes afectos de absceso epidural y trombosis de senos venosos fueron tratados con mastoidectomía (el 93,8 % y el 71,4 %, respectivamente). 13 El pronóstico de estas complicaciones suele ser favorable si se realiza el diagnóstico precoz y el tratamiento adecuado. 14 n…”

Section: Discussionunclassified

Mastoiditis aguda con complicación intracraneal. Reporte de un caso pediátrico

Aznar

Martínez²,

Fonz

et al. 2020

Arch Argent Pediat

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Presentación de casos clínicos RESUMEN La mastoiditis aguda es una infección de las celdillas mastoideas, generalmente, secundaria a la progresión de una otitis media aguda. Las bacterias aisladas con más frecuencia en las mastoiditis son Streptococcus pneumoniae, Streptococcus pyogenes y Staphylococcus aureus. La infección mastoidea puede extenderse por contigüidad, afectar a estructuras vecinas y dar lugar a complicaciones intra-o extracraneales. Las más frecuentes son las intracraneales, entre las que se incluyen la meningitis, el absceso cerebeloso o del lóbulo temporal, el absceso epi-o subdural y la trombosis de senos venosos. Se presenta el caso de una niña de 4 años que desarrolló dos complicaciones intracraneales (absceso epidural y trombosis de senos venosos transverso y sigmoideo) a partir de una mastoiditis aguda producida por Streptococus pyogenes.

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Management of acute complicated mastoiditis at an urban, tertiary care pediatric hospital

Abstract: 4. Laryngoscope, 127:2321-2327, 2017.

Cited by 31 publications

References 17 publications

Acute Otologic Infections in Pediatric Patients

Acute Otologic Infections in Pediatric Patients

The clinical course of children undergoing mastoidectomy due to complicated mastoiditis

Mastoiditis aguda con complicación intracraneal. Reporte de un caso pediátrico

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