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Mastoid abscess in acute and chronic otitis media
Mazita Ami1, Zahirrudin Zakaria, Bee See Goh
1Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia.
Background:
Mastoid abscess remains a recognised complication of otitis media despite the advent of antibiotics. The objectives of this study were to describe the risk factors in patients with mastoid abscess following acute and chronic otitis media and discuss the management of this infection.
Method:
A retrospective analysis was done on all patients who underwent mastoidectomy for mastoid abscess from January 2002 to December 2007. Data on the patients' presentation, associated complications, management, and follow-up were analysed.
Results:
A total of 12 patients were enrolled in this study population. Group A consisted of patients with mastoid abscess preceded by acute otitis media, while Group B consisted of patients with mastoid abscess and chronic otitis media. In Group A (n = 7), 4 patients had a pre-morbid immunocompromised condition, but they did not have cholesteatoma. None of the patients in Group B (n = 5) had any pre-morbid illnesses. Out of 12 patients, 7 patients had associated extracranial complications, and 1 patient had intracranial complications. Most patients recovered well after mastoidectomy. Recurrence was noted in 1 patient who had acute lymphoblastic leukaemia.
Conclusion:
Mastoid abscess is still a recognised complication of acute otitis media, especially in patients who are immunocompromised. Immunocompetent patients may also develop mastoid abscess following chronic otitis media associated with cholesteatoma. Thus, early treatment of otitis media and close vigilant follow-up are advocated to ensure prompt detection of mastoid abscess complications.
Insights
Mastoid abscesses can still occur with otitis media, particularly in immunocompromised individuals. Early treatment and monitoring of ear infections are crucial for preventing complications.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Surgical Pathology
Background:
- Mastoid abscess is a recognized complication of otitis media, even with antibiotic use.
- Risk factors and management strategies for mastoid abscess require continued investigation.
Purpose of the Study:
- To identify risk factors associated with mastoid abscess in patients with acute and chronic otitis media.
- To discuss the effective management of mastoid abscess infections.
Main Methods:
- Retrospective analysis of 12 patients who underwent mastoidectomy for mastoid abscess between 2002 and 2007.
- Data collected included patient presentation, complications, management, and follow-up.
Main Results:
- Seven patients had acute otitis media with mastoid abscess; four were immunocompromised and lacked cholesteatoma.
- Five patients had chronic otitis media with mastoid abscess; none were pre-morbidly ill.
- Seven patients experienced extracranial complications, and one had intracranial complications; most recovered well post-mastoidectomy.
Conclusions:
- Mastoid abscess remains a complication of acute otitis media, especially in immunocompromised patients.
- Immunocompetent individuals can develop mastoid abscess from chronic otitis media with cholesteatoma.
- Prompt detection and management of otitis media are essential to prevent mastoid abscess complications.
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