Die akute Mastoiditis heute

Abstract

Acute mastoiditis is an acute inflammation of the mastoid process with bone erosion. It is a complication of acute otitis media, which is rare but with increasing incidence. Distinct characteristics are an erythema and oedematous swelling of the skin of the mastoid process. A fluctuant swelling points to a subperiosteal abscess. Laboratory examination and imaging only support the diagnostics. Therapy involves obligatory systemic antibiotic treatment. At the beginning of the inflammation a paracentesis can be sufficient. A mastoidectomy must be carried out if clear signs of an osseous necrolysis, such as a subperiosteal abscess, are present. The most frequent causative agents are gram positive cocci. Intraoperative smears are best suitable for microbiological diagnostics. Complications of acute mastoiditis are encroachments of the inflammation on neighbouring structures of the mastoid. In such cases a tomography is indicated and therapy is usually surgical.

Nd:YAGlaser‐assisted transendoscopic procedure for treatment of otitis media in a horse

“…; Fickweiler et al . ). Facial nerve paralysis occurs in 10–15% of dogs with lateral osteotomy of the tympanic bulla and may be temporary or permanent (Mason et al .…”

“…During human mastoidectomy and osteotomy of the tympanic cavity in alpacas and small animals, an incision of the overlying soft tissue is necessary to reach the tympanic cavity (Sharp ; Fickweiler et al . ; Sumner et al . ).…”

“…In man, mastoidectomy is indicated if medical treatment and centesis were unsuccessful. During human mastoidectomy and osteotomy of the tympanic cavity in alpacas and small animals, an incision of the overlying soft tissue is necessary to reach the tympanic cavity (Sharp 1990;Fickweiler et al 2007;Sumner et al 2012). Humans, alpacas and small animals have no guttural pouches, therefore a laserendosopic approach is not possible.…”

“…Possible complications described in human medicine after mastoidectomy include facial paresis, vertigo, deafness, meningitis and brain abscess (Cody et al 1964;Fickweiler et al 2007). Facial nerve paralysis occurs in 10-15% of dogs with lateral osteotomy of the tympanic bulla and may be temporary or permanent (Mason et al 1988).…”

“…Mastoidectomy is indicated, if medical treatment and centesis of otitis media are not successful. The mastoid process is debrided and the tympanic cavity is opened using a retroauricular approach under general anaesthesia (Fickweiler et al 2007). In horses, this surgical procedure to cure otitis media nonresponsive to medical treatment has not been described in the literature.…”