[Mastoiditis--a forgotten disease?]

The symptoms and clinical course of latent mastoiditis in 18. children treated in Polish-American Children's Hospital in Cracow were presented. The ultimate diagnosis of mastoiditis was based on typical findings on antrotomy and the presence of granulation on histology of the tissue obtained during the operation. The main symptoms of latent mastoiditis were: a lack of appetite, chronic or recurrent fever and failure to thrive. 11 children (61%) had experienced more than 3 episodes of acute otitis media before the diagnosis of mastoiditis was established. Bacteria most commonly isolated from the middle ear were those of Staphylococcus, Streptococcus and Proteus species. Radiograms of mastoid processes were negative in up to 45% of those children. The mean duration of antibiotic therapy was 10.7 weeks. After antrotomy complete dissolution of symptoms were observed in 14 patients (78%). It is concluded, that in the presence of symptoms suggesting latent mastoiditis, the possibility of antrotomy, which may shorten the period of ineffective antibiotic therapy, should be considered earlier.