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Published on: May 23, 2021
Acute mastoiditis: predictors for surgery
E Kvestad1, K J Kvaerner, I W Mair
1Department of Otorhinolaryngology, Ullevål University Hospital, N-0407, Oslo, Norway.
Insights
Acute mastoiditis incidence in children decreased, with surgery less frequent. Longer symptom duration and elevated inflammatory markers predicted mastoidectomy need.
Area of Science:
- Pediatrics
- Otolaryngology
- Infectious Diseases
Background:
- Acute mastoiditis is a serious complication of acute otitis media.
- Mastoidectomy rates have varied historically, necessitating updated incidence and predictor data.
Purpose of the Study:
- To estimate the incidence of acute mastoiditis in children.
- To identify predictors for mastoidectomy in pediatric patients.
Main Methods:
- Retrospective case record study of 38 children hospitalized for acute mastoiditis in Oslo (1989-1998).
- Analysis of clinical data, including symptom duration, prior otitis media, and inflammatory markers.
Main Results:
- The incidence of mastoidectomy significantly decreased compared to 1970-1979.
- Predictors for mastoidectomy included symptom duration (≥6 days), elevated white blood cell count, and C-reactive protein.
- Children undergoing mastoidectomy had a longer overall hospital stay.
Conclusions:
- Early referral to otolaryngology is recommended for children with suspected acute mastoiditis.
- Identifying predictive factors can aid in timely surgical intervention decisions.
Abstract:
To estimate the incidence of acute mastoiditis and identify predictors for mastoid surgery, a retrospective case record study of 38 children hospitalised for acute mastoiditis in Oslo from 1989 to 1998 was performed. Median age at diagnosis was 18 months and 13 (34%) of the children received mastoidectomy. Compared to the period 1970-1979, the incidence of mastoidectomy was significantly reduced. Only seven children (18%) had experienced acute otitis media prior to the current episode. Symptom duration of 6 days or more prior to hospitalisation and elevated white blood cell counts and C-reactive Protein were predictive for mastoidectomy ((OR = 5.0 (1.0-22.8), (OR = 24.5 (2.5-240) and OR = 10.5 (1-108.8)). Furthermore, total time from symptom onset to hospital discharge was significantly higher in children who received mastoidectomy. We suggest early referral to an otolaryngologic department in children suspected of acute mastoiditis.
