This report consists of an analysis with observations of 526 consecutive operations for acute or chronic mastoiditis which were performed in the services of otology and pediatrics in the same hospital on 466 patients from 1930 to 1939 inclusive. No attempt was made to differentiate between patients treated with sulfonamide compounds and those not so treated, although patients receiving such therapy during the last few years were included. However, the much lower average in the number of operations during the last three years than during the first seven years may be due to the general use of these drugs.There were 342 mastoidectomies on 288 patients with acute mastoiditis and 179 radical mastoidectomies on 173 patients and 5 modified radical (Heath) mastoidectomies on 5 patients with chronic mastoiditis. Thus 65 per cent of the operations were for acute mastoiditis and 35 per cent for chronic. In addition to those mentioned, 4 patients with mastoiditis were admitted to the hospital and died without operation.Comparing Kafka's1 incidence of 65.11 per cent acute and 34.89 per cent chronic mastoiditis in a series of 3,225 cases from Bellevue Hospital in New York with my findings of 65 per cent acute and 35 per cent chronic, one might conclude that in a large city hospital the operations for acute mastoiditis outnumber the radical operations for chronic mastoiditis by about 2 to 1.
INCIDENCELateral Distribution of Mastoiditis.\p=m-\With the acute type of mastoiditis the incidence on the two sides was equal, each 40 per cent, while with the chronic type the incidence on the left side exceeded that on the right side. Bilateral acute mastoiditis occurred in 18.8 per cent of patients (table 1). Table 2 gives comparative figures for other series.The term "simple mastoidectomy," while still in common use, is not appropriate, for the reason that many so-called simple mastoidectomies are far from simple. Many are very extensive and complicated. Therefore the term "mastoidectomy for acute mastoiditis," or merely "mastoidectomy," in contradistinction to "radical" or "modified radical" mastoidectomy, is preferable. Lacy2 said that the term "complete mastoidectomy" should be used instead of "simple mastoidectomy." Sex.\p=m-\When the acute and the chronic condition were considered together, the sexes were found to be about evenly divided : Two hundred and thirty-one (49.6 per cent) were males and 235 (50.4 per cent) were females. With the conditions considered separately, the sex incidence was a follows: Acute : 152 (52.7 per cent) males and 136 (47.3 per cent) females. Chronic: 79 (44.4 per cent) males and 99 (55.6 per cent) females.These figures are compared with those of other authors in table 3.
