Acute Mastoiditis in Children as Persisting Problem

Abstract

OBJECTIVE: Acute mastoiditis is serious otological condition which may cause difficult, sometimes fatal complications. The aim of the study is to present our experiences in diagnosis and treatment of acute mastoiditis in children. MATERIALS and METHODS:Medical records of 52 children with diagnosis of acute mastoiditis were reviewed retrospectively. Data on clinical presentation, laboratory tests, microbiological and radiological features, prehospital treatment and delay in making the diagnosis, hospital treatment and outcome were analyzed. A relationship between white blood cell count or level of C-reactive protein and therapeutic protocols was investigated. RESULTS:All children were admitted as emergency patients and were treated with intravenous antibiotics. Almost 15% of patients were not examined by a doctor prior to hospitalization. The conservative treatment was successfully conducted in 15% of patients. One-third of the patients were recovered after myringotomy. Almost a half of the patients underwent surgical procedure such as antrotomy, mastoidectomy or tympanomastoidectomy. Computed tomography (CT) scan was done in patients with signs of developing complications and those with no improvement after the beginning of treatment. CONCLUSION:Acute mastoiditis is still persisting problem in our health care system. An early diagnosis and adequate treatment of acute mastoiditis is essential in order to prevent serious complications.

Pediatric Acute Mastoiditis: Our Experience in a Tertiary Care Center

“…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.…”

“…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 ].…”

“…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].…”

“…The incidence of AM in the pediatric age group is increasing [ 5 ], even more in developed countries [ 1 , 6 , 7 ]. A similar tendency has been observed for suppurative intracranial complications of AM [ 8 ].…”