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Updated: Jun 22, 2026
07:06
Endaural Endoscopic Atticoantrotomy (Retrograde Mastoidectomy) using a Constant Suction Bone-drilling Technique
Published on: May 23, 2021
Advanced pediatric mastoiditis with and without intracranial complications
Jose P Zevallos1, Jeffrey T Vrabec, Robert A Williamson
1Bobby R. Alford Department of Otolaryngology, Texas Children's Hospital, Houston, USA.
The Laryngoscope
|June 9, 2009
Summary
Pediatric advanced mastoiditis cases are rising. Intracranial complications were linked to a higher incidence of anaerobic bacteria, emphasizing the need for appropriate antibiotic coverage.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
- Neurosurgery
Background:
- Increasing incidence of advanced pediatric mastoiditis and intracranial complications.
- Need to understand the role of bacteriology in complication development.
Purpose of the Study:
- Review the bacteriology of advanced mastoiditis in pediatric patients.
- Hypothesize that bacteriology differences explain intracranial complication development.
Main Methods:
- Retrospective chart review of pediatric patients with coalescent mastoiditis requiring surgery (2002-2007).
- Surgical specimens analyzed for pathology, Gram stain, aerobic, and anaerobic cultures.
- Patients categorized by mastoidectomy alone or transtemporal craniotomy for intracranial complications.
Main Results:
- 108 pediatric patients identified; 17% had intracranial complications.
- Streptococcus pneumoniae was the most common organism.
- Anaerobic isolates were significantly more frequent in patients with intracranial complications (29.4% vs. 5.7%, P=.015).
Conclusions:
- Nearly a quarter of pediatric patients with coalescent mastoiditis had simultaneous intracranial complications.
- Increased anaerobic organisms in complicated cases highlight the importance of anaerobic coverage.
- Aggressive surgical management and infectious disease collaboration are crucial for advanced pediatric mastoiditis.
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