Mastoiditis in adults: a 19-year retrospective study

Area of Science:

• Otolaryngology
• Infectious Diseases
• Radiology

Background:

• Acute mastoiditis is a serious complication of otitis media, particularly in adults.
• Adult cases are less common than pediatric cases and may present with atypical features.

Purpose of the Study:

• To retrospectively review clinical, radiological, and therapeutic findings in adult acute mastoiditis.
• To analyze the incidence, presentation, complications, and treatment outcomes of adult mastoiditis.

Main Methods:

• Retrospective chart review of 62 adult patients with acute mastoiditis treated between 1992 and 2010.
• Inclusion criteria included otitis media, postauricular signs, fever, and/or radiological evidence of mastoiditis.
• Treatment strategies included conservative management (antibiotics, ventilation tubes) and surgical interventions (mastoidectomy, mastoido-tympanoplasty).

Main Results:

• The incidence of adult mastoiditis was stable at approximately 0.99 cases/year/100,000 inhabitants.
• Typical clinical presentation occurred in 48% of cases; complications included meningitis (15 cases), facial nerve paralysis (11), and labyrinthitis (8).
• Complete cure was achieved with conservative treatment in 69% of uncomplicated cases and 24% of complicated cases; facial palsy recovered fully in most instances.

Conclusions:

• Adult mastoiditis can present with both acute classical and insidious latent forms, often with atypical clinical features.
• The incidence of severe complications, particularly meningitis, remains high in adults, especially the elderly.
• Early clinical suspicion and prompt diagnosis are essential for effective management and to prevent severe outcomes.