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Acute mastoiditis in children: the "Ferrara" experience
S Palma1, E Fiumana, M Borgonzoni
1Department of Audiology, University of Ferrara, Arcispedale sant'Anna-Corso della Giovecca 203, 44100 Ferrara, Italy.
Insights
Acute mastoiditis in children requires careful clinical assessment, especially in those under two years old. Close collaboration between otologists and pediatricians is crucial to manage risk factors and prevent severe complications.
Area of Science:
- Pediatric Otolaryngology
- Infectious Diseases
Background:
- Acute mastoiditis is a serious complication of acute otitis media.
- Early diagnosis and management are crucial to prevent severe outcomes.
Purpose of the Study:
- To investigate clinical features and outcomes of acute mastoiditis in children.
- To identify risk factors and predictors for surgical intervention.
Main Methods:
- Retrospective study of 55 children diagnosed with acute mastoiditis.
- Inclusion criteria: otoscopical evidence of acute otitis media and mastoid inflammation.
- Data collected from case sheets between 1994 and 2005.
Main Results:
- 13 patients underwent mastoidectomy with a median hospital stay of 15 days.
- Complications in the mastoidectomy group included meningitis, meningoencephalitis, sinus thrombosis, and facial palsy.
- Non-surgical treatments included antibiotics, tympanocentesis, and ventilation tube placement.
Conclusions:
- The incidence of otomastoiditis shows periodic variations, with a potential increase in some regions.
- Children aged two years or younger are at higher risk for clinical complications.
- Close collaboration between otologists and pediatricians is recommended for optimal patient care.
Objective:
This study aims to investigate the clinical features and outcomes of acute mastoiditis in children referred to the ENT/Audiology Department of the University of Ferrara from January 1994 to December 2005. It also aims to discuss risk factors and to find predictors for surgery.
Methods:
A retrospective study on case sheets of children with an acute mastoiditis diagnosis was carried out. Fifty-five cases fulfilled the inclusion criteria: they presented otoscopical evidence of acute otitis media and inflammatory findings of the mastoid area such as post-auricular swelling, redness or tenderness, protrusion of the auricle and/or radiological findings.
Results:
Twenty-six patients were only treated with antibiotic therapy, tympanocentesis alone was performed in 11 cases; in 5, a ventilation tube was positioned. Mastoidectomy was performed in 13 patients. The group who underwent mastoidectomy had a median hospital stay of 15 days (5-54), in this group were found the following complications: 1 meningitis, 1 meningo-encephalitis, 1 lateral and sigmoid sinus thrombosis, 1 facial palsy.
Conclusion:
the incidence of otomastoiditis does not seem to be decreasing, on the contrary, in some countries, it seems to be on the increase. Our experience cannot confirm a real increase of the incidence but we noted periodic variations during the time of observation. It is important, that careful attention is paid to the clinical assessment of children who are 2-years old or under, as they seem to be more exposed to the risk of clinical complications; therefore, it is highly recommended that the otologist and the paediatrician collaborate closely.
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