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Incidental finding of mastoid opacification in computed tomography imaging of the asymptomatic paediatric population

Published online by Cambridge University Press:  04 July 2019

T Placanica  and
S Anderson
T Placanica*
Affiliation:
Department of ENT, Townsville Hospital, Australia
S Anderson
Affiliation:
Department of ENT, Townsville Hospital, Australia
*
Author for correspondence: Dr Thomas Placanica, 135 Central Avenue, Sherwood, 4075 QLD, Australia E-mail: thomas.placanica@gmail.com
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Abstract

Background

Acute mastoiditis is a clinically diagnosed suppurative infection of the mastoid air cells and is the most common complication of acute otitis media. Opacification of the mastoid air cells is a commonly reported radiological finding and patients are often erroneously diagnosed with acute mastoiditis when this is present.

Objectives

This study aimed to quantify incidental findings of mastoid opacification in the asymptomatic paediatric population and contribute to the epidemiological data.

Method

A retrospective cohort study was conducted of all paediatric patients who underwent relevant computed tomography imaging for a non-otological indication.

Results

Data were collected from 767 patients in total. Mastoid opacification was reported in 82 patients. The prevalence was highest in patients aged zero to one year (n = 25, prevalence = 20.3 per cent), followed by those aged two to three years (n = 17, prevalence = 19.5 per cent).

Conclusion

Mastoid opacification is a common incidental finding in the asymptomatic paediatric population, with prevalence rates between 5 per cent and 20 per cent depending on age. The prevalence peaks in patients aged zero to four years (19–20 per cent) and is inversely correlated with increasing age.

Keywords

MastoiditisInfantChildAdolescentTomography, X-Ray Computed
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 7 , July 2019 , pp. 588 - 591
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr T Placanica takes responsibility for the integrity of the content of the paper

References

1Bluestone, CD, Klein, JO. Intratemporal complications and sequelae of otitis media. In: Bluestone, CD, Casselbrant, ML, Stool, SE, eds. Pediatric Otolaryngology, 4th edn. Philadelphia: Saunders, 2003;687Google Scholar
2Groth, A, Enoksson, F, Hultcrantz, M, Stalfors, J, Stenfeldt, K, Hermansson, A. Acute mastoiditis in children aged 0–16 years--a national study of 678 cases in Sweden comparing different age groups. Int J Pediatr Otorhinolaryngol 2012;76:1494–500Google Scholar
3Shapiro, R. Radiology of the Normal Skull. Chicago: Year Book Medical Publishers, 1981;326–40Google Scholar
4Thompson, PL, Gilbert, RE, Long, PF, Saxena, S, Sharland, M, Wong, IC. Effect of antibiotics for otitis media on mastoiditis in children: a retrospective cohort study using the United Kingdom general practice research database. Pediatrics 2009;123:424–30Google Scholar
5Ghaffar, FA, Wördemann, M, McCracken, GH Jr. Acute mastoiditis in children: a seventeen-year experience in Dallas, Texas. Pediatr Infect Dis J 2001;20:376–80Google Scholar
6Thorne, MC, Chewaproug, L, Elden, LM. Suppurative complications of acute otitis media: changes in frequency over time. Arch Otolaryngol Head Neck Surg 2009;135:638–41Google Scholar
7Kvaerner, KJ, Bentdal, Y, Karevold, G. Acute mastoiditis in Norway: no evidence for an increase. Int J Pediatr Otorhinolaryngol 2007;71:1579–83Google Scholar
8Choi, SS, Lander, L. Pediatric acute mastoiditis in the post-pneumococcal conjugate vaccine era. Laryngoscope 2011;121:1072–80Google Scholar
9Cherry, JD, Calzada, AP, Shapiro, NL. Mastoiditis. In: Cherry, JD, Demmler-Harrison, GJ, Kaplan, SL, Steinbach, W, Hotez, P, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases, 7th edn. Philadelphia: Elsevier Saunders, 2014;233Google Scholar
10van den Aardweg, MT, Rovers, MM, de Ru, JA, Albers, FW, Schilder, AG. A systematic review of diagnostic criteria for acute mastoiditis in children. Otol Neurotol 2008;29:751–7Google Scholar
11Wald, ER, Conway, JH. Mastoiditis. In: Long, SS, Pickering, LK, Prober, CG, eds. Principles and Practice of Pediatric Infectious Diseases, 4th edn. Edinburgh: Elsevier Saunders, 2012;222Google Scholar
12Tamir, S, Schwartz, Y, Peleg, U, Perez, R, Sichel, JY. Acute mastoiditis in children: is computed tomography always necessary? Ann Otol Rhinol Laryngol 2009;118:565–9Google Scholar
13Stähelin-Massik, J, Podvinec, M, Jakscha, J, Rüst, ON, Greisser, J, Moschopulos, M et al. Mastoiditis in children: a prospective, observational study comparing clinical presentation, microbiology, computed tomography, surgical findings and histology. Eur J Pediatr 2008;167:541–8Google Scholar
14Singh, S, Rettiganti, MR, Qin, C, Kuruva, M, Hegde, SV. Incidental mastoid opacification in children on MRI. Pediatr Radiol 2016;46:704–8Google Scholar
15Wilkinson, SL, Sahota, RS, Constable, JD, Harper, F, Judd, O. Does incidental mastoid opacification on computerized tomography necessitate referral to ENT? Laryngoscope 2017;127:2860–5Google Scholar
16von Kalle, T, Fabig-Moritz, C, Heumann, H, Winkler, P. Incidental findings in paranasal sinuses and mastoid cells: a cross-sectional magnetic resonance imaging (MRI) study in a pediatric radiology department. Rofo 2012;184:629–34Google Scholar
17Polat, S, Aksoy, E, Serin, GM, Yıldız, E, Tanyeri, H. Incidental diagnosis of mastoiditis on MRI. Eur Arch Otorhinolaryngol 2011;268:1135–8Google Scholar
18Abbas, Y, Yuen, HS, Trinidade, A, Watters, G. Incidental mastoiditis on magnetic resonance imaging scans: clinical relevance and cost implications. J Laryngol Otol 2018;132:1010–12Google Scholar
19Paluska, TR, Sise, MJ, Sack, DI, Sise, CB, Egan, MC, Biondi, M. Incidental CT findings in trauma patients: incidence and implications for care of the injured. J Trauma 2007;62:157–61Google Scholar
20Anson, BJ, Donaldson, JA. Surgical Anatomy of the Temporal Bone, 3d edn. Philadelphia: Saunders, 1981Google Scholar
21Schillinger, R. Pneumatization of the mastoid. Radiology 1939;33:54–67Google Scholar