Acute mastoiditis in a Norwegian population: a 20 year retrospective study

Vassbotn, Flemming S.; Klausen, Olav G.; Lind, Ola; Möller, Per

doi:10.1016/s0165-5876(01)00626-7

Cited by 64 publications

(46 citation statements)

References 12 publications

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“…Some reports state that in most pediatric patients there is no evidence supporting that CT-Scan alters patient outcome [4,14,20]. However, other authors suggest that clinical examination is not able to identify all cases of complications and therefore additional exams should be performed whenever the patient is treated conservatively [21]. In our department, CT-Scan was widely used, especially in the last years (after May 2005 all but one child was submitted to this exam)- Table 3.…”

Section: Discussionmentioning

confidence: 99%

Acute mastoiditis in children: Middle ear cultures may help in reducing use of broad spectrum antibiotics

Garcia

Salgueiro

Luís

et al. 2017

International Journal of Pediatric Otorhinolaryngology

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a b s t r a c tBackground: Acute mastoiditis (AM) is a suppurative infection of the mastoid air cells, representing the most frequent complication of acute otitis media. AM remains an important entity in children due to its potential complications and sequelae. We aim to describe the cases of AM admitted at our department, identify risk factors potentially associated with complications and analyse the changes in clinical approach of AM over time. Methods: Case review of clinical files of children admitted with acute mastoiditis from June 1996 to May 2013 at a Lisbon metropolitan area hospital. Data was divided into two groups (prior and after May 2005) in order to evaluate changes in AM approach over the years. Results: 135 AM episodes were included. The median age was 3.8 years and 42% children were less than 24 months of age. Symptoms at presentation included fever (69%), ear pain (56%) and otorrhea (40%). Complications occurred in 22% patients and were more common in children under 24 months (33% vs 15%, p 0.01). Leukocyte count was significantly higher in children with complications (16.7 vs 14.5 Â 10 9 /mL, p 0.05) as was C-Reactive Protein value (13 vs 6.3 mg/dL, p 0.001). There was a significant association between the development of complications and C-Reactive Protein value at admission (OR 1.892; IC95%: 1.018 e2.493, p 0.01). The optimal cut-off value was 7.21 mg/dL. Over time there was a significant increase in middle ear cultures obtained by tympanocentesis during surgery (2% vs 16%, p 0,01) and also a decrease in the use of broad spectrum antibiotherapy as initial treatment (52% vs 25%,p 0,001). Conclusions: Children under 24 months, with high leukocyte count or with high C-Reactive Protein value should be monitored closely since complications tend to be more frequent. A CRP value of 7.21 mg/dL at admission seems to be a good cut-off to monitor children for potential complications. Throughout the period analysed more cultures were performed allowing identification of the pathogens and implementation of appropriate antibiotic therapy.

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Section: Discussionmentioning

confidence: 99%

Acute mastoiditis in children: Middle ear cultures may help in reducing use of broad spectrum antibiotics

Garcia

Salgueiro

Luís

et al. 2017

International Journal of Pediatric Otorhinolaryngology

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“…Flohr and Schultz (2009a) identified bone alterations associated with mastoiditis in 83.4% of human skeletal remains from two early medieval German cemeteries, but with the introduction of antibiotic therapy, mastoiditis became a rare consequence of otitis media in the industrialized world, although it is still common in developing countries (e.g. Tarantino et al, 2002;Vassbotn et al, 2002). …”

Section: Introductionmentioning

confidence: 99%

Differentiating between rhinosinusitis and mastoiditis surgery from postmortem medical training: A study of two identified skulls and hospital records from early 20th century Coimbra, Portugal

Magalhães

Lopes

Santos

2017

International Journal of Paleopathology

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Differentiating between medical procedures performed antemortem, perimortem or postmortem in skeletal remains can be a major challenge. This work aims to present evidence of procedures to treat rhinosinusitis (RS) and mastoiditis, suggest criteria for the diagnosis of frontal sinus disease, and frame the individuals described in their medical historical context. In the International Exchange collection, the skull (878) of a 24-year-old male, who died in 1933 due to frontal sinusitis and meningitis, presents evidence of a trepanation above the right frontonasal suture, and micro/macroporosity on the superciliary arches. The available Coimbra University Hospitals archives reported that 46 females and 59 males (aged 15 months-84 y.o., x− = 35.33) underwent surgery to treat RS, primarily by trepanation (94.3%). In a search for similar evidence in the collection, the skull of a 42-year-old female (85), who died in 1927 due to sarcoma in the abdomen, shows four quadrangular holes located above the right supraorbital notch, right and left maxilla, and left mastoid process. The number/location of the holes and cut marks point to postmortem medical training (possible dissection). This paper discusses the value of information from historical contexts to differentiate between surgery and medical training in the paleopathological record.

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“…However, results of the present study indicate that the number of patients with mastoiditis did not increase in the area of southern Sweden that was studied. Recent studies support that the trend toward less liberal use of antibiotics against AOM does not seem to increase the number of cases of mastoiditis [2][3][4]. However, other authors have reported an increase in the number of mastoiditis patients in recent years [5][6][7][8][9].…”

Section: Discussionmentioning

confidence: 97%

Acute mastoiditis in southern Sweden: a study of occurrence and clinical course of acute mastoiditis before and after introduction of new treatment recommendations for AOM

Stenfeldt

Hermansson

2010

Eur Arch Otorhinolaryngol

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Watchful waiting was recommended as an option for uncomplicated episodes of acute otitis media in Sweden in the year 2000. Concern was raised that these recommendations would lead to a higher incidence of acute mastoiditis. The aim of this study was to map the occurrence, treatment policy and the clinical course of mastoiditis before and after the new treatment recommendations were introduced. Included in the study were all patients (adults and children) who were admitted to two ENT departments in southern Sweden for acute mastoiditis from 1996 to 2005. A total of 42 cases of mastoiditis were identified: 23 during the first period of 1996-2000 and 19 during 2001-2005. Mastoidectomy was performed in 14 patients during the first period and in 8 during the second period. As much as 39% of mastoiditis patients received antibiotics before hospital care, but had no improvement. There was no indication that the number of patients with acute mastoiditis was increasing after new treatment recommendation of AOM. There was no increase in the occurrence of mastoidectomy. Severe complications of mastoiditis were rare. Although there were potentially threatening complications of mastoiditis in the study, these did not lead to sequelae. It is important to follow up the consequences when treatment recommendations of AOM are changed.

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Acute mastoiditis in a Norwegian population: a 20 year retrospective study

Cited by 64 publications

References 12 publications

Acute mastoiditis in children: Middle ear cultures may help in reducing use of broad spectrum antibiotics

Acute mastoiditis in children: Middle ear cultures may help in reducing use of broad spectrum antibiotics

Differentiating between rhinosinusitis and mastoiditis surgery from postmortem medical training: A study of two identified skulls and hospital records from early 20th century Coimbra, Portugal

Acute mastoiditis in southern Sweden: a study of occurrence and clinical course of acute mastoiditis before and after introduction of new treatment recommendations for AOM

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