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Endaural Endoscopic Atticoantrotomy Retrograde Mastoidectomy using a Constant Suction Bone-drilling Technique
Published on: May 23, 2021
Risk factors for recurrent acute mastoiditis in pediatric patients: a registry-based cohort study
Yotam Aharon Shiner1,2, Orit Samuel3,4,5, Walid Saliba4,5
1Department of Otolaryngology, Head and Neck Surgery, Lady Davis Carmel Medical Center, Haifa, Israel. yotamsh@clalit.org.il.
Insights
Recurrent acute mastoiditis in children is linked to mastoidectomy and mastoid swelling during the initial episode. Mastoidectomy is the primary independent risk factor for recurrent acute mastoiditis.
Area of Science:
- Pediatric Otolaryngology
- Infectious Diseases
Background:
- Acute mastoiditis is a serious bacterial infection of the mastoid bone.
- Recurrence of acute mastoiditis presents unique challenges in pediatric management.
- Identifying risk factors for recurrence is crucial for effective treatment strategies.
Purpose of the Study:
- To characterize pediatric patients experiencing recurrent acute mastoiditis.
- To determine significant risk factors associated with recurrent acute mastoiditis in children.
Main Methods:
- Retrospective cohort study utilizing electronic medical records from a large Israeli Health Maintenance Organization.
- Identified and verified cases of acute mastoiditis in children hospitalized between 2008-2018.
- Compared characteristics of patients with recurrent mastoiditis to the initial cohort to identify risk factors.
Main Results:
- 1115 cases of acute mastoiditis were identified; 5.1% (57/1115) experienced recurrence.
- Recurrent cases predominantly affected children younger than 24 months (73.4%).
- Mastoidectomy (HR=4.7) and mastoid swelling (HR=2.55) during the first episode were significant risk factors; mastoidectomy was the sole independent predictor in multivariate analysis.
Conclusions:
- Mastoidectomy is a significant independent risk factor for recurrent acute mastoiditis in children.
- Swelling over the mastoid area during the initial episode also increases the risk of recurrence.
- These findings highlight the importance of considering surgical history and initial presentation in managing acute mastoiditis to prevent recurrences.
Objective:
To describe characteristics of pediatric patients with recurrent acute mastoiditis, and to identify risk factors for this condition.
Study Design:
A retrospective cohort study.
Setting:
Data based on electronic medical records of the largest Health Maintenance Organization in Israel.
Methods:
Children hospitalized due to acute mastoiditis during the years 2008-2018 were identified, and their diagnosis was verified. Patients with recurrent acute mastoiditis were identified and grouped, and their characteristics were outlined and compared to those of the original group to identify risk factors for recurrence.
Results:
During the 11-year period, a total of 1115 cases of children hospitalized due to acute mastoiditis were identified with a weighted incidence rate of 7.8/100,000. Of this group, 57 patients were diagnosed with recurrence following a full clinical recovery. The incidence proportion of recurrent acute mastoiditis was 5.1% (57/1115), male-to-female ratio was 27:30, 73.4% were younger than 24 months, the median period from the first episode was 3.4 months (IQR 2.0;10.0), and 82.5% of the patients (n = 47) had a single recurrence, whereas 18.5% (n = 10) had two recurrences or more. Mastoidectomy and swelling over the mastoid area during the first episode were identified as the main risk factors for recurrent mastoiditis HR = 4.7 [(2.7-8.2), p < 0.001] and HR = 2.55 [(1.4-4.8), p = 0.003], respectively. Mastoidectomy was the only independent significant risk factor for recurrence in a multivariate analysis.
Conclusions:
Mastoidectomy and swelling over the mastoid area during the first episode of acute mastoiditis were found strongly related independent risk factor for future recurrent episodes of acute mastoiditis.
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