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Published on: May 23, 2021
Acute mastoiditis: 30 years review in a tertiary hospital
Aida Veiga-Alonso1, Natalia Roldán-Pascual2, Rosa María Pérez-Mora1
1Department of Otolaryngology, Marqués de Valdecilla University Hospital, Santander, Spain.
Insights
This study analyzed acute mastoiditis in children in Cantabria, Spain. Most cases were treated successfully with antibiotics, with surgery reserved for severe cases, showing low complication rates.
Area of Science:
- Pediatrics
- Otolaryngology
- Infectious Diseases
Background:
- Acute mastoiditis is a common complication of acute otitis media in children.
- Understanding its clinical-epidemiological profile is crucial for effective management.
Purpose of the Study:
- To analyze the clinical-epidemiological characteristics of acute mastoiditis in children under 18 in Cantabria, Spain.
- To propose evidence-based diagnostic and treatment recommendations for acute mastoiditis.
Main Methods:
- A 30-year retrospective study of 111 pediatric patients diagnosed with acute mastoiditis.
- Analysis included epidemiological data, clinical presentation, causative agents, treatment strategies, and follow-up outcomes.
Main Results:
- The incidence was 3.9 per 100,000 children annually, with most patients under 2 years old.
- Streptococcus pneumoniae was the most frequent pathogen; antibiotics like third-generation cephalosporins were common.
- Surgical intervention (myringotomy, mastoidectomy) was needed for 29% of patients, with rare complications (5.4% retroauricular abscesses).
Conclusions:
- Acute mastoiditis incidence in Cantabria aligns with developed countries.
- Conservative antibiotic treatment is effective for many; imaging and surgery are reserved for non-responders.
- Complications are infrequent, though recurrent acute otitis media occurred in 32% of cases post-treatment.
Objective:
Acute mastoiditis, the most common complication of acute otitis media, is approached in our study, focused on children from the Autonomous Community of Cantabria, Spain. The aim is to analyze its clinical-epidemiological characteristics and propose diagnostic and treatment recommendations.
Study Design/Setting:
We conducted a 30-year retrospective study on patients under 18 years of age diagnosed with acute mastoiditis in Cantabria.
Methods:
We analysed epidemiological data, clinical presentation, causes, treatment, and follow-up.
Results:
We included 111 patients, 60.4 % of which were under 2 years old. The average incidence was 3.9/100,000 children per year. Streptococcus pneumoniae was the most common microorganism. Third-generation cephalosporins and amoxicillin-clavulanic acid were the most frequently used antibiotics. 19 % of patients underwent temporal bone CT scans. Twenty-nine children required surgical intervention, primarily myringotomy and mastoidectomy. Only 5.4 % developed retroauricular abscesses. During follow-up, 32 % experienced new acute otitis media cases.
Conclusions:
The incidence of acute mastoiditis in Cantabria is similar to that of other developed countries. Imaging studies are reserved for cases with poor progression. Conservative management with antibiotics is suitable for many patients, with surgery reserved for poor responders. Complications are rare in our setting.
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