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Conservative management of acute mastoiditis in children

David Bakhos1, Jean-Paul Trijolet, Sylvain Morinière

  • 1Centre Hospitalier Régional Universitaire de Tours, Université François Rabelais de Tours, Unité pédiatrique d'ORL et CCF, 2 boulevard Tonnele, 37044 Tours, France. bakhos_d@med.univ-tours.fr

Archives of Otolaryngology--Head & Neck Surgery
|April 20, 2011
PubMed

Insights

Antibiotic treatment combined with retroauricular puncture and grommet insertion effectively treats acute mastoiditis in children, offering a less invasive alternative to mastoidectomy.

Area of Science:

  • Pediatric Otolaryngology
  • Infectious Diseases
  • Surgical Innovation

Background:

  • Acute mastoiditis in children often requires surgical intervention.
  • Mastoidectomy has been the traditional treatment for subperiosteal abscess (SA) in acute mastoiditis.
  • Minimally invasive approaches are sought to reduce surgical morbidity.

Purpose of the Study:

  • To evaluate the efficacy of antibiotics with retroauricular puncture and grommet insertion for acute mastoiditis.
  • To compare this conservative approach with traditional mastoidectomy.

Main Methods:

  • Retrospective study of 50 children under 14 with acute mastoiditis.
  • Analysis of treatment outcomes before and after 2002, when conservative management was introduced.
  • Inclusion criteria: antibiotic treatment, exclusion of subacute mastoiditis and cholesteatoma.

Main Results:

  • All children achieved cure without complications, irrespective of treatment.
  • The number of subperiosteal abscesses remained similar before and after 2002.
  • Mastoidectomies significantly decreased after the introduction of conservative management (16 vs. 1).
  • Shorter hospital stays were observed for patients treated with aspiration compared to mastoidectomy.

Conclusions:

  • Antibiotics combined with retroauricular puncture and grommet insertion are effective for acute mastoiditis with SA.
  • This conservative approach reduces the need for mastoidectomy in pediatric patients.
  • This strategy offers a viable, less invasive alternative to surgery.
Abstract

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