Acute mastoidectomy in a Danish county from 1977 to 1997 - operative findings and long-term results

Abstract

Petersen CG, Ovesen T, Pedersen CB. Acute mastoidectomy in a Danish county from 1977 to 1997-operati6e findings and long-term results. Acta Otolaryngol 2000; Suppl 543: 122-126.Data from patients undergoing acute mastoidectomy were examined retrospectively to evaluate if the nature of acute mastoiditis (AM) treated surgically has changed during the last 20 years (1977 -97). Moreover, a prevalence study was conducted to clarify the otological and audiological course following acute mastoidectomy. Patients with cholesteatoma and intracranial complications were excluded. Thus, 79 patients with a median age of 16 months were included. Thirty-seven percent had a history of middle ear disease, and the mean duration from onset of symptoms to admission was 9 days. Well-being was affected in 46%, and 82% had fever. The clinical picture was dominated by auricular protrusion (77%) and pathological tympanic membrane (94%). Postauricular oedema, hyperaemia and tenderness were demonstrated in 89%, 78% and 49% of cases, respectively. Peroperatively, purulent middle ear effusion was recognized in 92%, subperiosteal abscess in 66% and pus in the mastoid in 90%. Specimens revealed growth of pathogens in 58%, predominantly Gram-positive bacteria. The observation period was 1 -20 years. The findings in operated ears were not significantly different from the contralateral non-operated ears concerning incidence of otitis media, hearing and ear canal volume. Conclusively, acute mastoidectomy is a safe and effective treatment to eliminate infection. The operation can be done with negligible risk and does not leave long-term sequelae. Key words: acute mastoidectomy, long-term results, operati6e findings.

Therapeutic approach to pediatric acute mastoiditis – an update

“…Having reviewed literature data, it can be stated that the differences between the centers regarding performing mastoidectomy are wide and vary from 9% to 88%. 4 , 16 , 18 , 21 , 22 , 23 On the basis of 73 children treated in our center we can conclude that AM treatment protocol suggested proved to be safe and helped us to successfully cure the patients with AM ( Fig. 1 ).…”

“…Pedersen et al, reported a group of 79 patients with AM. 18 In all cases mastoidectomy was performed and turned out to be a very effective treatment with no longterm negative impact on the child, minimal rate of complications, thus being reported as a treatment of choice in acute AM. 18 …”

“…In the current literature the differences regarding both the diagnosis and management of AM in children are relatively substantial. 3 , 4 , 8 , 15 , 16 , 17 , 18 …”

Characteristics of pediatric recurrent acute mastoiditis: A case–control study

“…Recurrent mastoiditis is commonly defined as a recurring mastoiditis event at least 4‐weeks after a mastoiditis event that completely resolves clinically 12,13 . The estimated incidence of recurrent mastoiditis is 5%–18% of mastoiditis cases 12–19 . Causative pathogens, such as Pseudomonas aeruginosa , anaerobic bacteria, and polymicrobial infection, a local abscess, a history of recurrent AOM, or of a mastoidectomy procedure, have all been proposed as risk factors.…”

“…12,13 The estimated incidence of recurrent mastoiditis is 5%-18% of mastoiditis cases. [12][13][14][15][16][17][18][19] Causative pathogens, such as Pseudomonas aeruginosa, anaerobic bacteria, and polymicrobial infection, a local abscess, a history of recurrent AOM, or of a mastoidectomy procedure, have all been proposed as risk factors. Nevertheless, most of these causes have been refuted and no consensus on causes has been established.…”