Acute mastoiditis in pediatric population

Teresa Ryczer, *Lidia Zawadzka-Głos, Małgorzata Dębska, Monika Jabłońska-Jesionowska

Summary
Introduction. Among intratemporal complications of acute otitis media, acute mastoiditis (AM) is the most common one. The diagnosis is based mainly on the clinical features, though radiological imaging can be helpful in more serious cases. The management consist of conservative and surgical treatment.
Material and methods. The retrospective analysis of patients with acute mastoiditis hospitalized in the Department of Pediatric Otolaryngology of Medical University of Warsaw from January 2011 to January 2013 was done. Data assessed included demographic characteristics, the type of complications, applied antibiotic therapy and surgical treatment.
Results. 24 patients with acute mastoidits were admitted to the hospital. The median age was 3.86 years (age range: 8 months to 13 years). Myringotomy was done in 20 patients (83%). Simple mastoidectomy was performed in 9 cases (37.5%). 6 patients had mastoid subperiosteal abscess. The standard antibiotic treatment was in most cases cefuroxime and clindamycin. In 3 patients the cause of mastoiditis was chronic inflammation process.
Conclusions. Acute mastoiditis occurs in most cases due to acute inflammatory process. The initial management always involves broad-spectrum antibiotic therapy. If there is no tympanic membrane perforation with otorrhea, myringotomy should be performed. In case of mastoid subperiosteal abscess, simple mastoidectomy (antromastoidectomy) can be indispensable, although abscess drainage plus myringotomy has been discussed in literature as equally good treatment.

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