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Acute mastoiditis in children: is surgical treatment necessary?

Published online by Cambridge University Press:  29 June 2007

R. Cohen-Kerem ,
N. Uri ,
H. Rennert ,
N. Peled ,
E. Greenberg  and
M. Efrat
R. Cohen-Kerem*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Carmel Medical Center, Haifa, Israel.
N. Uri
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Carmel Medical Center, Haifa, Israel.
H. Rennert
Affiliation:
Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel.
N. Peled
Affiliation:
Department of Radiology, Carmel Medical Center, Haifa, Israel.
E. Greenberg
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Carmel Medical Center, Haifa, Israel.
M. Efrat
Affiliation:
Department of Pediatrics, Carmel Medical Center, Haifa, Israel.
*
Address for correspondence: R. Cohen-Kerem, M.D., Department of Otolaryngology – Head and Neck Surgery, Carmel Medical Center, 7 Michal Street, 34362 Haifa, Israel. Fax: +972-4-8250683 E-mail: nrkerem@netvision.net.il
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Abstract

Acute mastoiditis in children remains an otological problem. Although the widespread use of antibiotics has reduced the need for surgical intervention, surgery is frequently used in the treatment of acute mastoiditis and its complications. The charts of 44 patients hospitalized with signs of acute mastoiditis were reviewed. In 43.2 per cent of all patients, acute mastoiditis was the presenting sign of acute middle-ear infection. Post-auricular erythema and protrusion of the auricle were the most frequent signs at presentation. All four signs (post-auricular erythema, oedema, tenderness, and protrusion of the auricle) were present in 40.9 per cent of patients. No bacterial pathogen was isolated in 45.5 per cent of ear cultures. Complicated acute mastoiditis was diagnosed in 13.7 per cent of the patients. Eighty-seven per cent of patients responded well to intravenous antibiotics and myringotomy, and in 11.4 per cent mastoidectomy or abscess drainage were performed. We conclude that nearly all patients with uncomplicated mastoiditis recover following intravenous antibiotics and myringotomy. Mastoidectomy should be perfonned in selected cases, such as cases of complicated acute mastoiditis.

Keywords

ChildMastoiditisSurgery, operativeAntibiotics
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 113 , Issue 12 , December 1999 , pp. 1081 - 1085
Copyright
Copyright © JLO (1984) Limited 1999

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