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Contemporary management of paediatric acute mastoiditis in Aotearoa New Zealand

Annabel Noakes1, Jonathan Stevenson2, Philip Bird3

  • 1Department of Surgery, Christchurch Hospital, Christchurch, New Zealand.

International Journal of Pediatric Otorhinolaryngology
|June 3, 2026
PubMed

Insights

Conservative management for paediatric acute mastoiditis (AM) shows promising outcomes. Medical therapy or conservative surgery for uncomplicated AM and incision and drainage for sub-periosteal abscesses are effective options.

Area of Science:

  • Otolaryngology
  • Pediatric Infectious Diseases
  • Surgical Management

Background:

  • Paediatric acute mastoiditis (AM) incidence is rising globally.
  • There's a growing trend towards less invasive management strategies for AM.
  • Contemporary AM management in Aotearoa New Zealand requires evaluation.

Purpose of the Study:

  • To assess current treatment approaches for paediatric acute mastoiditis in New Zealand.
  • To analyze the effectiveness of various management strategies for uncomplicated and complicated AM.
  • To identify trends in conservative management for paediatric AM.

Main Methods:

  • Retrospective observational study of paediatric AM patients (<18 years).
  • Data collected from five tertiary hospitals in Aotearoa New Zealand (2014-2022).
  • Analysis of treatment strategies and outcomes for uncomplicated and complicated AM cases.

Main Results:

  • 212 AM cases: 49% uncomplicated, 51% complicated (including sub-periosteal abscess, meningitis, venous sinus thrombosis).
  • Uncomplicated AM managed with medical therapy (52%), conservative surgery (40%), or mastoidectomy (8%).
  • Sub-periosteal abscesses treated with incision/drainage (53%) or mastoidectomy (33%); no significant outcome differences between strategies.

Conclusions:

  • Conservative management, including medical therapy or conservative surgery for uncomplicated AM, is a viable option.
  • Incision and drainage for sub-periosteal abscesses is an effective approach.
  • Current conservative strategies appear safe and effective for paediatric acute mastoiditis.
Abstract

Keywords:
Acute mastoiditisMastoidectomyPaediatricSub-periosteal abscess

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