Paediatric acute mastoiditis, then and now: is it more of a problem now?

Attlmayr, B; Zaman, Shakeel Uz; Scott, June; Derbyshire, S G; Clarke, R. W.; S, De

doi:10.1017/s0022215115002078

Cited by 13 publications

(14 citation statements)

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“…Our incidence of 49 cases over seven years is slightly higher than that recently presented by a similar centre located elsewhere in the UK. 7 Our patient population also has an older median age and a wider range than described in studies conducted elsewhere in the UK, 7 but is within the range described by international studies. 5,8,9 The average length of stay was similar to that seen in a similar UK centre, 7 but was typically less than that seen in international series.…”

Section: Discussionsupporting

confidence: 59%

“…7 Our patient population also has an older median age and a wider range than described in studies conducted elsewhere in the UK, 7 but is within the range described by international studies. 5,8,9 The average length of stay was similar to that seen in a similar UK centre, 7 but was typically less than that seen in international series. 5,8,9 The retrospective nature of the study precluded specifying the diagnostic criteria used in each case, but each patient received a clinical diagnosis of acute mastoiditis from an experienced ENT surgeon.…”

Section: Discussionsupporting

confidence: 59%

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Acute mastoiditis in children: contemporary opportunities and challenges

et al. 2020

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BackgroundMastoiditis is the most common intra-temporal complication of acute otitis media. Despite potentially lethal sequelae, optimal management remains poorly defined.MethodA retrospective case review was conducted of children diagnosed with mastoiditis at a tertiary referral centre, in North East England, between 2010 and 2017.ResultsFifty-one cases were identified, 49 without cholesteatoma. Median patient age was 42 months (2 months to 18 years) and median hospital stay was 4 days (range, 0–27 days). There was no incidence trend over time. Imaging was conducted in 15 out of 49 cases. Surgery was performed in 29 out of 49 cases, most commonly mastoidectomy with (9 out of 29) or without (9 out of 29) grommets. Complications included sigmoid sinus thrombosis (3 out of 49) and extradural abscess (2 out of 51), amongst others; no fatalities occurred.ConclusionA detailed contemporary description of paediatric mastoiditis presentation and management is presented. The findings broadly mirror those published by other UK centres, but suggest a higher rate of identified disease complications and surgical interventions.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionsupporting

confidence: 59%

Acute mastoiditis in children: contemporary opportunities and challenges

et al. 2020

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“…Contrast-enhanced CT is estimated to have an 80% positive predictive value and a 90% negative predictive value in the diagnosis of intracranial complications [27]. Different opinions are presented with regard to indications to CT scans; as a result, the percentage of patients in whom CT scans were performed ranges from 0.5 to 86% [11,12,17,18,20,22,23,33]. In a Danish study in a population of 214 patients, CT scan was performed in only one case [15].…”

Section: Discussionmentioning

confidence: 99%

Acute mastoiditis in children population

Zonenberg¹,

Hassmann‐Poznańska

Skotnicka

et al. 2019

Pol Otorhino Rev

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Aim: The aim of the study was to perform a retrospective analysis of the medical documentation of patients treated for acute mastoiditis (AM) at the Department of Pediatric Otolaryngology in Bialystok and to review the available literature on this subject so as to determine optimum AM management principles. Material and methods:A retrospective analysis of 40 patients treated for AM in 2001-2017 was performed. Patient enrollment was based on the AM diagnostic criteria established by Anthonsen et al [15]. results:The mean age of the subjects was 46 months, with 37% of children being less than 2 years old. No previous episodes of acute otitis media (AOM) had been reported in 2/3 of cases. Prior to hospital admission, antibiotics had been administered to 69% of patients. In laboratory investigations, 95% of patients presented with elevated inflammation markers (CRP, leukocytosis), with the values of these markers being higher in patients qualified for surgery. Indications for computed tomography (CT) scans included lack of improvement following 48 hours of conservative treatment or the presence of symptoms of subperiosteal abscesses. CT scans were performed in 35% of patients. Conservative treatment alone was administered to 24 patients (60%); this included myringotomy with/without ventilation tube insertion and intravenous antibiotic therapy. Ceftriaxone was the most commonly used antibiotic, being administered to 75% of patients. Mastoidectomy was required in 16 patients. The most common indication (30%) for mastoidectomy consisted in the presence of subperiosteal abscess. conclusion:In non-complicated cases of AM, there is no need for routine performance of CT scans; myringotomy with or without insertion of ventilation drains should be performed and empirical intravenous antibiotic therapy should be started.In the presence of a subperiosteal abscess, a contrast-enhanced CT scan and mastoidectomy are recommended. Deterioration of patient's condition or lack of improvement after 48 hours of conservative treatment requires a CT scan being performed and the decision on potential mastoidectomy being made on the basis of the scan. Keywords:acute mastoiditis, children, acute otitis media, treatment streszczenie: cel: Celem pracy była analiza retrospektywna dokumentacji chorych leczonych z powodu ostrego zapalenia wyrostka sutkowatego (OZWS) w Klinice Otolaryngologii Dziecięcej w Białymstoku, jak również dostępnego piśmiennictwa na ten temat, w celu określenia optymalnych zasad postępowania w OZWS. Materiał i metody:Analiza retrospektywna 40 pacjentów leczonych z powodu OZWS w latach 2001-2017. Kryteria włączenia pacjentów przyjęto za Anthonsen i wsp.[15]. wyniki: Średni wiek badanych wynosił 46 miesięcy, 37% dzieci miało mniej niż 2 lata. 2/3 przypadków nie było poprzedzonych wcześniejszymi epizodami OMA. 69% chorych otrzymywało antybiotyk przed przyjęciem do szpitala. W badaniach laboratoryjnych u 95% chorych stwierdzono podwyższone wykładniki stanu zapalnego (CRP, leukocytoza), ich wartość była wyższa wśród chorych zak...

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“…Anticoagulation is not indicated in management of lateral sinus thrombosis according to most authors [15,16]. According to Attlmayr and colleagues, the improvement in imaging technologies and aids may explain the apparent increase of intracranial complications [17].…”

Section: Discussionmentioning

confidence: 99%

Acute Otomastoiditisin Children: Clinical Presentations and Management

Bechraoui¹

2018

IJO

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Acute mastoiditis (AC) is a serious complication of acute otitis media (AOM) affecting, in most cases, the pediatric population. Diagnosis is usually easy in front of a retro auricular swelling associated to OM. However, this disease may cause significant and even life threatening complications beyond the tympanomastoid system such as peripheral facial nerve palsy, Bezold's abscess, meningitis, subperiosteal abscess and brain abscess. Management of AC remains controversial raging from conservative treatment in the form of IV antibiotics to more aggressive interventions such as mastoidectomy. This retrospective study represents our experience in the management of AC in the pediatric population. Our purpose was to review and discuss clinical presentations and main treatment modalities of AM.

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Paediatric acute mastoiditis, then and now: is it more of a problem now?

Abstract: The numbers of paediatric patients presenting with acute mastoiditis appears essentially unchanged. Improvement in imaging technology and aids to interpretation may explain the apparent increase of intracranial complications.

Cited by 13 publications

References 14 publications

Acute mastoiditis in children: contemporary opportunities and challenges

Acute mastoiditis in children: contemporary opportunities and challenges

Acute mastoiditis in children population

Acute Otomastoiditisin Children: Clinical Presentations and Management

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