Subperiosteal abscesses in acute mastoiditis in 115 Swedish children

Enoksson, Frida; Groth, Anita; Hultcrantz, Malou; Stalfors, Joacim; Stenfeldt, Karin; Hermansson, Ann

doi:10.1016/j.ijporl.2015.05.002

Cited by 23 publications

(16 citation statements)

References 19 publications

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“…Of these 55 articles, 19 evaluated outcomes after initial or sole treatment with medical therapy and were used for quantitative analysis . An additional 36 articles discussed surgical therapy as an initial treatment option (with or without medical therapy); 33 has specific details on treatment that allowed for quantitative analysis (Fig. ) …”

Section: Resultsmentioning

confidence: 99%

Medical Versus Surgical Treatment of Pediatric Acute Mastoiditis: A Systematic Review

et al. 2018

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Objective There is no standard of care for treatment of pediatric acute mastoiditis (PAM). We systematically reviewed the English literature to evaluate the efficacy of PAM treatment options. Methods PubMed, Embase, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library were searched from inception to January 2016, along with manual bibliography searches, for studies describing surgical or medical therapy. Two independent evaluators reviewed each abstract and article. Results We identified 310 articles, and 55 met inclusion criteria. Thirty‐three evaluated surgical options and included 2,930 patients (mean age = 2.8 years) including those with myringotomy ± tube placement (n = 920); 140 needed additional surgery, drainage of subperisoteal abscess (SPA) (n = 142) ± myringotomy or tube placement, 29 patients needed additional surgery and mastoidectomy ± myringotomy or tube placement (n = 612), with 611 reporting resolution. Using a random effects model, the estimated success probability with 95% confidence intervals (CI) are myringotomy ± tube placement 94% (95% CI: 84.5%‐97.8%), and drainage of subperiosteal abscess with concurrent myringotomy ± tube placement was 86.5% (95% CI: 66.4%‐95.4%). Using a random effects model, mastoidectomy success was 99.7% (95% CI: 77.5%‐100%). Nineteen studies evaluated medical therapy (n = 990 patients). The average cure rate was 71.7% (median = 70%; range, 26.3%–100%), and estimated success was 72.9% (95% CI: 60.5%‐82.5%) by meta‐analysis. Conclusions Myringotomy with or without tube placement and mastoidectomy have the highest cure rates for PAM. With SPA, incision and drainage with myringotomy with or without tube can be considered. Medical treatment cured nearly 72% of children. Ultimately, management should be based on surgeons' experience and judgment, patient characteristics, and severity of disease. Laryngoscope, 129:754–760, 2019

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Section: Resultsmentioning

confidence: 99%

Medical Versus Surgical Treatment of Pediatric Acute Mastoiditis: A Systematic Review

et al. 2018

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“…Sixty-eight articles were selected for full-text assessment after abstract screening. Twenty-one articles were eventually selected for final inclusion and data extraction 15 35 The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram for article inclusion is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Management of paediatric acute mastoiditis: systematic review

2017

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“…The widely established management of non-complicated AM, which is also practiced at our site, consists of myringotomy with or without ventilation tube placement and intravenous antibiotic therapy [13]. Patients who fail to improve after 48 hours of this management require radiological diagnostic examinations and an-of infection with F. necrophorum, it is necessary to include an antibiotic active against anaerobic bacteria [18,20].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, articles have been published which suggest that mastoidectomy may not be necessary even in the case of subperiosteal abscesses. According to the authors of these publications, puncture or incision of the abscess combined with intravenous antibiotic therapy are sufficient to ensure resolution in most patients [10,13,20,21,22,42]. However, the analysis performed by Anne et al [4] suggested that mastoidectomy was still required in 12.5% of patients treated in this manner.…”

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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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Subperiosteal abscesses in acute mastoiditis in 115 Swedish children

Cited by 23 publications

References 19 publications

Medical Versus Surgical Treatment of Pediatric Acute Mastoiditis: A Systematic Review

Medical Versus Surgical Treatment of Pediatric Acute Mastoiditis: A Systematic Review

Management of paediatric acute mastoiditis: systematic review

Acute mastoiditis in children population

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