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Incidental mastoid opacification on computed tomography in the pediatric population
David J Lafferty1, Jason E Cohn1, Brian J McKinnon2
1Department of Otolaryngology-Head and Neck Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA; Department of Pediatric Otolaryngology, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA, USA.
Incidental mastoid opacification (IMO) is common in children, affecting 14.2% of cases. This pediatric finding is rarely clinically significant, with few requiring otolaryngology consultation.
Area of Science:
- Radiology
- Pediatric Otolaryngology
Background:
- Incidental mastoid opacification (IMO) is a frequent radiologic finding in pediatric computed tomography (CT) scans.
- IMO often leads to referrals to otolaryngologists, necessitating evaluation of its clinical significance.
Purpose of the Study:
- To determine the prevalence of IMO in a pediatric population.
- To identify children with clinical mastoiditis.
- To ascertain factors associated with the need for otolaryngology consultation for IMO.
Main Methods:
- Retrospective chart review of pediatric patients with 'mastoid' keyword on CT reports.
- Analysis of age, gender, season, and contrast media use on IMO rates.
- Chi-square analysis for statistical significance.
Main Results:
- The overall rate of IMO was 14.2% in the pediatric cohort.
- IMO was more prevalent in younger children (<8 years: 22.0%) and males (16.6%).
- Otolaryngology consultation was rare (3%), and no cases presented with clinical mastoiditis.
Conclusions:
- This study represents the largest analysis of pediatric incidental mastoid opacification on CT.
- Despite a 14.2% prevalence, IMO in children is infrequently clinically significant.
- The majority of pediatric IMO cases do not warrant otolaryngology intervention.
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