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[Mastoiditis in childhood]
J Lautermann1, B Lieberum, J Schaper
1Universitäts-Hals-, Nasen- und Ohrenklinik Essen.
Background:
Despite new antibiotics mastoiditis in children still is a serious infection confronting the pediatrician and otolaryngologist with diagnostic and therapeutic problems.
Patients And Methods:
In a retrospective study we reviewed the charts of 48 children who had a mastoidectomy from 1990 to 1995 in the Department of Oto-Rhino-Laryngology at the University of Essen.
Results:
60% of the patients presented with a retroauricular swelling, and a pathologic tympanic membrane was found in 89%. The erythrocyte sedimentation rate as the most valuable laboratory parameter was increased in 95% of cases. Larger osteodestructive lesions as a complication of mastoiditis could be predicted in three of ten cases by plain x-ray of the temporal bone. The most common bacteria to be isolated were Staphylococcus aureus, Streptococcus pneumoniae and Pseudomonas aeruginosa.
Conclusion:
Because of potential endocranial complications (10% in our patients) as well as difficult radiologic diagnosis of osteodestructive lesions by plain x-ray, we advocate mastoidectomy instead of a mere pharmacological therapy in the treatment of mastoiditis.