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Mastoiditis in children
C N Bitar1, E A Kluka, R W Steele
1Department of Pediatrics, Louisiana State University School of Medicine, New Orleans, USA.
Insights
Mastoiditis incidence has decreased, but computed tomographic (CT) scans aid in managing chronic cases by detailing cholesteatomas and surgical risks. CT is crucial for acute mastoiditis with suspected complications.
Area of Science:
- Pediatric Otolaryngology
- Infectious Diseases
Background:
- Mastoiditis, an infection of the mastoid bone, presents in acute and chronic forms.
- Historically, mastoiditis was more prevalent, with significant changes observed since 1950.
Purpose of the Study:
- To analyze clinical presentations and management of pediatric mastoiditis over a 10-year period.
- To evaluate the impact of computed tomographic (CT) scans on diagnosing and managing mastoiditis.
Main Methods:
- Retrospective review of 57 pediatric cases of mastoiditis diagnosed between 1984 and 1994.
- Analysis of clinical data, bacterial pathogens, and the utility of CT scans in disease management.
Main Results:
- A marked decrease in mastoiditis incidence compared to historical data.
- Clinical features and bacterial pathogens remain consistent with previous literature.
- CT scans significantly improved the surgical management of chronic mastoiditis by delineating cholesteatomas and anatomical variations.
Conclusions:
- Despite decreased incidence, mastoiditis requires careful management.
- CT scanning is essential for evaluating chronic mastoiditis and guiding surgical interventions.
- CT is indicated in acute mastoiditis when chronic suppuration or bone destruction is suspected.
Abstract:
Fifty-seven children were seen over a 10-year period, 1984-1994, at two large pediatric referral centers with a diagnosis of mastoiditis. Twelve had acute infection and 45 had chronic manifestations. Clinical presentations and recovered bacterial pathogens were identical to those reported in earlier literature although the incidence of both acute and chronic mastoiditis has decreased markedly since 1950. The availability of computed tomographic (CT) scans during this decade has improved the management of chronic disease by defining the location of cholesteatomas and the extent of disease as well as possible anatomic variations and potential complications encountered during surgery. CT scanning is indicated in acute disease when there is suspicion of chronic suppuration or destruction of the mastoid.