[Influence of the COVID-19 pandemic on acute mastoiditis in children - a multicentric study]

Already in 2021 it was reported, that the COVID-19 pandemic influences the incidence of acute mastoiditis in children. The goal of this multicenter cross-regional study was to collect and analyze a substantial pre-, peri- and postpandemic data set.Absolute case frequencies were inquired from six segments: epidemiology, medical history taking, spectrum of pathogens, course of disease, therapy, and imaging. Nine ENT clinics in Germany reported about a 6 year time frame from 2018 to 2024.251 acute mastoiditis emergency cases were seen. There occured 69 pre-pandemic, 31 pandemic, and 151 post-pandemic cases, 100 female and 151 male. Among the general symptoms, fever was most frequent with 160 cases, and among the ear-specific symptoms, retrauricular ones (633 symptoms). The spectrum of pathogens was narrow, in only 21 out of 240 laboratory tests (8.8%) different pathogens than the four offered were found. In 42.2% of mastoiditis patients, a temporal bone CT scan was performed, surgical therapy took place in 223 cases. Complications, surgical therapy and spectrum of pathogens did not show changes in percentage.Postpandemic cases of pediatric acute mastoidites were more than twice the number of prepandemic cases. Surgical treatment in combination with antibiosis was the therapy of choice in 90%. Over the course of the pandemic, no changes of spectrum of pathogens, presentation, complications or epidemiology were observed.