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Acute mastoiditis in children: presentation and long term consequences

Published online by Cambridge University Press:  19 July 2007

Abstract

Acute mastoiditis, a destructive bacterial infection of the mastoid bone and air cell system, is relatively uncommon today but remains a potentially serious condition. There is a lack of information in the literature regarding the long term otological problems that children may face following an episode of this condition.

Objectives:

Our aim was to examine the presentation, complications and hospital course in this patient population, and to ascertain whether these patients had long term otological problems.

Methods:

We retrospectively reviewed the medical records of all patients presenting with acute mastoiditis between January 1990 and December 2005. Patients' parents were contacted by telephone and questioned about further otological problems.

Results:

Twenty-nine patients were included in the study, and 27 of these patients' parents were contactable to complete the telephone questionnaire. Sixty-nine per cent of children had no previous history of acute otitis media prior to presentation. Forty-five per cent of patients had received oral antibiotics prior to presentation. Sixty-two per cent of patients developed complications, i.e. a subperiosteal abscess or failure to respond to medical therapy, resulting in the need for surgical intervention (in the form of incision and drainage of periosteal abscess, cortical mastoidectomy, or grommet insertion). Mean follow up of patients was eight years and one month; five (17 per cent) patients had been followed up for less than one year. Two (7 per cent) patients developed a further episode of mastoiditis within six weeks of initial presentation, both of whom required cortical mastoidectomy. Three (10 per cent) patients had further problems with recurrent acute otitis media, requiring tympanostomy tube insertion. One patient required a modified radical mastoidectomy for cholesteatoma (15 years later). Twenty-two patients (91 per cent) had been followed up for longer than one year; these patients had subjectively normal hearing and were asymptomatic at the time of study.

Conclusion:

The majority of patients who had suffered an episode of acute mastoiditis had no adverse long term otological sequelae.

Type
Research Article
Copyright
Copyright © JLO (1984) Limited 2007

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References

1 McKenna, MH, Eavey, RD. Acute mastoiditis. In: Nadol, J, Schuknect, H, eds. Surgery of the Ear and Temporal Bone. New York: Raven Press; 1993;145–54Google Scholar
2 Gliklich, RE, Eavey, RD, Lannuzzi, RA, Alfonso, E, Camacho, R. A contemporary analysis of acute mastoiditis. Arch Otolaryngol Head Neck Surg 1996;122:135–910.1001/archotol.1996.01890140023006Google Scholar
3 Scott, TA, Jackler, RK. Acute mastoiditis in infancy: a sequela of unrecognized acute otitis media. Otolaryngol Head Neck Surg 1989;101:683–6Google Scholar
4 Nadal, D, Herrmann, P, Baumann, A, Fanconi, A. Acute mastoiditis: clinical, microbiological and therapeutic aspects. Eur J Pediatr 1990;149:560–4Google Scholar
5 Hawkins, DB, Dru, D, House, JW. Acute mastoiditis in children: a review of 54 cases. Laryngoscope 1983;93:568–72Google Scholar
6 Leskinen, K, Jero, J. Complications of acute otitis media in children in southern Finland. Int J Pediatr Otorhinolaryngol 2004;68:317–24Google Scholar
7 Niv, A, Nash, M, Slovik, Y, Fliss, DM, Kaplan, D, Leibovitz, E et al. Acute mastoiditis in infancy: the “Soroka” experience: 1990–2000. Int J Pediatr Otorhinolaryngol 2004;68:1435–9Google Scholar
8 Hoppe, JE, Koster, S, Bootz, F, Niethammer, D. Acute mastoiditis – relevant once again. Infection 1994;22:178–82Google Scholar
9 Van Zuijlen, DA, Schilder, AG, Van Balen, FA, Hoes, AW. National differences in incidence of acute mastoiditis: relationship to prescribing patterns of antibiotics for acute otitis media. Pediatr Infect Dis J 2001;20:1012–13Google Scholar