Management of acute mastoiditis in children. A retrospective study and literature review

Abid, W.; Gamra, O. Ben; Ghorbal, H.; Cherif, Intissar; Zribi, S.; Hriga, I.; Mbarek, C.

doi:10.1016/j.ejenta.2014.05.001

Cited by 4 publications

(13 citation statements)

References 7 publications

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“…In patients lacking clinical improvement, mastoidectomy should be performed within 24-48 hours. Other authors have also described conservative management of SA and simple mastoidectomy can be performed in non-responsive cases [2,3,10,[12][13][14][15]. The treatment of SA has been long debated, but we followed the motto "Ubi pus ibi evacua" (where you find pus, remove it).…”

Section: Discussionmentioning

confidence: 99%

“…AM most commonly results as a complication of acute inflammation of the middle ear. It mainly affects the pediatric population [ 1 , 2 , 5 ]. Diagnosis is based on clinical signs of postauricular swelling, erythema, tenderness, and forward protrusion of the auricle.…”

Section: Discussionmentioning

confidence: 99%

“…It could be because young children are least immunologically prepared to fight highly virulent organisms and diagnosis of AOM is difficult to make due to the narrow external auditory canal which is often obstructed with wax. Moreover, the possibility of hematogenous spread of infection without underlying otitis media has also been postulated in literature [ 1 , 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…Erosion of mastoid can be seen well with a CT scan. Radiological investigations of small children are used with caution due to the need for general anesthesia and the risks involved with irradiation [ 2 , 3 ]. In developing countries like ours, it is also a luxury only afforded by the wealthy.…”

Section: Discussionmentioning

confidence: 99%

“…Acute mastoiditis (AM) is likely to develop as a complication of acute otitis media (AOM) [1][2][3]. AM is the most common and feared complication of AOM, which causes serious and life-threatening complications beyond the temporal bone, including meningitis, epidural, and subdural abscess, brain abscess, and lateral sinus thrombophlebitis [4].…”

Section: Introductionmentioning

confidence: 99%

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Pediatric Acute Mastoiditis: Our Experience in a Tertiary Care Center

Shrestha¹,

Pokharel²,

Dhakal³

et al. 2021

Cureus

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IntroductionAcute mastoiditis (AM) is a common intra-temporal complication of acute otitis media (AOM) and is more commonly seen in children. Occasionally, it presents as the first sign of ear disease. This study aimed to evaluate the clinical course of AM and determine therapeutic options for pediatric patients presenting with AM. MethodsThis was a prospective, observational study conducted on patients with AM presenting at a tertiary center during one year period. Convenience sampling was employed and 79 pediatric patients (18 years or below) were recruited for the study. Data on the demographic profile of patients, the treatment offered, duration of hospital stay, and outcome were analyzed. ResultIn our study, 62% were male patients (n = 49) and 38% (n = 30) were females. The mean age of patients was 9.32 ± 5.3 years and a history of AOM was present in 60 (75.9%). On admission, the most common presentation was post-auricular inflammation (100%) followed by otalgia (79.7%), fever (59.5%), aural protrusion (54.4%), and otorrhoea (51.9%). Culture reports were available for 54 (68.4%) patients and 30 (38%) grew organisms. The cultured organisms were Streptococcus pneumonia (20.3%), Pseudomonas aeruginosa (10.1%), Streptococcus pyogenes (3.8%), and Staphylococcus aureus (3.8%). Most patients were managed conservatively (n = 66, 83.5%) whereas surgery was performed in 16.5% (n = 13) patients. The mean hospital stay was 5.58 ± 1.99 days. The need for surgical management was significantly associated with age >5 years (p = 0.006), history of AOM (p = 0.026) and the presence of complications (p = 0.012). Subperiosteal abscess (SA) was present in 21 (26.6%) patients and one had facial palsy. SA along with AM had a mean hospital stay of 8.5 ± 0.77 days compared to 4.94 ± 1.43 days in case of isolated AM (p < 0.001) and the mean age of presentation in SA with AM was 11.97 ± 5.13 years compared to 8.29 ± 5.14 years in case of isolated AM (p = 0.006). All patients recovered and were followed up to three months with no recurrence, complications, or sequelae. ConclusionMost of the cases of acute mastoiditis follow previous AOM episodes. With early recognition and effective treatment, the prognosis is good.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Pediatric Acute Mastoiditis: Our Experience in a Tertiary Care Center

Shrestha¹,

Pokharel²,

Dhakal³

et al. 2021

Cureus

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Therapeutic approach to pediatric acute mastoiditis – an update

Mierzwiński

Tyra

Haber

et al. 2019

Brazilian Journal of Otorhinolaryngology

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The main points of the management protocol are: initiate a broad-spectrum intravenous antibiotic treatment; mastoidectomy should be performed if the infection fails to be controlled after 48h of administering intravenous antibiotic therapy. We believe that early mastoidectomy prevents serious complications, and our initial observation is that by performing broad mastoidectomy with posterior attic and facial recess exposure, recurrence of acute mastoiditis can be prevented.

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