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Acute mastoiditis in children: contemporary opportunities and challenges
M Mather1, S Powell1, P D Yates1
1Department of Otolaryngology, Great North Children's Hospital, Newcastle upon Tyne, UK.
Insights
Pediatric mastoiditis, a complication of acute otitis media, requires clear management guidelines. This study details 51 cases, highlighting complications and surgical interventions in children.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
- Surgical Complications
Background:
- Mastoiditis is the most frequent intra-temporal complication of acute otitis media.
- Despite potential severe outcomes, optimal management strategies for mastoiditis are not well-established.
- This study addresses the need for contemporary data on pediatric mastoiditis.
Purpose of the Study:
- To describe the presentation and management of pediatric mastoiditis.
- To analyze complications and surgical interventions in children with mastoiditis.
- To provide contemporary data for comparison with existing literature.
Main Methods:
- Retrospective case review of children diagnosed with mastoiditis.
- Study conducted at a tertiary referral center in North East England.
- Data collected between 2010 and 2017.
Main Results:
- Fifty-one cases of pediatric mastoiditis were identified, predominantly without cholesteatoma.
- Median patient age was 42 months, with a median hospital stay of 4 days.
- Complications included sigmoid sinus thrombosis and extradural abscess; no fatalities were reported. Surgical intervention was common.
Conclusions:
- A comprehensive overview of contemporary pediatric mastoiditis cases is presented.
- Findings align with other UK studies but indicate a potentially higher incidence of complications and surgical procedures.
- Further research into optimal management protocols for pediatric mastoiditis is warranted.
Background:
Mastoiditis is the most common intra-temporal complication of acute otitis media. Despite potentially lethal sequelae, optimal management remains poorly defined.
Method:
A retrospective case review was conducted of children diagnosed with mastoiditis at a tertiary referral centre, in North East England, between 2010 and 2017.
Results:
Fifty-one cases were identified, 49 without cholesteatoma. Median patient age was 42 months (2 months to 18 years) and median hospital stay was 4 days (range, 0-27 days). There was no incidence trend over time. Imaging was conducted in 15 out of 49 cases. Surgery was performed in 29 out of 49 cases, most commonly mastoidectomy with (9 out of 29) or without (9 out of 29) grommets. Complications included sigmoid sinus thrombosis (3 out of 49) and extradural abscess (2 out of 51), amongst others; no fatalities occurred.
Conclusion:
A detailed contemporary description of paediatric mastoiditis presentation and management is presented. The findings broadly mirror those published by other UK centres, but suggest a higher rate of identified disease complications and surgical interventions.
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