Imaging of Complications of Acute Mastoiditis in Children

Abstract

Acute mastoiditis is a serious complication of acute otitis media in children. Suppurative disease in the mastoid region occasionally spreads to the adjacent dura mater of the posterior and middle cranial fossae and the sigmoid sinus by means of thrombophlebitis, osseous erosion, or anatomic pathways, producing intracranial complications. Computed tomography (CT) should be performed early in the course of the disease to classify the mastoiditis as incipient or coalescent and to detect intracranial complications. On the basis of the clinical features and imaging findings, the disease is managed conservatively with intravenously administered antibiotics or treated with mastoidectomy and drainage plus antibiotic therapy. CT is therefore a decisive diagnostic tool in determining the type of therapy. In addition, magnetic resonance imaging is performed in patients with clinical symptoms or CT findings suggestive of intracranial complications because of its higher sensitivity for detection of extraaxial fluid collections and associated vascular problems.

MR Imaging Features of Acute Mastoiditis and Their Clinical Relevance

“…While the usefulness of MR imaging in diagnosing intracranial AM spread has been demonstrated many times over, 1,[5][6][7][8][9] intratemporal findings of AM on MR imaging tend to be overlooked and information on their clinical relevance is scarce. Problems exist with overdiagnosing "mastoiditis" on MR imaging if it is based on intramastoid fluid signal alone.…”

Zygomatic Abscess with Temporomandibular Joint Effusion Complicating Acute Otitis Media

“…Thus, there must be a high index of suspicion during the management of these patients, and early CT scans of the temporal bone are essential. If a complication is found, MRI should be the next imaging technique to help surgical planning (20). In our case, an abscess was not detected through a CT scan but was detected through MRI.…”

A Pictorial Review of Complications of Acute Coalescent Mastoiditis

“…Radiographic fi ndings of mastoiditis range from subtle changes of mastoid air cell opacifi cation to the more profound changes of osseous destruction, subperiosteal abscess formation, coalescent mastoiditis, and, in some cases, venous infarctions as well as parenchymal abscesses (1)(2)(3). Middle ear infection may spread to the mastoid cells through the aditus ad antrum.…”