Manifest mastoiditis in childhood: a current critical review

We made a follow-up study on forty children from our patient material, which had been operated because of manifest mastoiditis. We could establish the following: the number of operations has been increasing in recent years while there has been a significant drop in the number of cases with a preceding phase of otitis. A very characteristic pathological alteration, viz. the proliferation of granular tissue was found during the operation indicating that a short anamnestic period is illusory since before the mastoiditis manifests itself, there has obviously been a latent, long-lasting inflammatory process which apparently goes on without symptoms. Antibiotics, their excessive and unnecessary dosage, together with viral infections reducing immunity, may play a considerable role in the occurrence of these characteristic changes.