Acute mastoiditis in children: contemporary opportunities and challenges

• Published in: Journal of laryngology and otology Vol. 134; no. 5; pp. 434 - 439
• Main Authors: Mather, M, Powell, S, Yates, P D, Powell, J
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.05.2020
• Subjects: Abscesses; Antibiotics; Antimicrobial agents; Children; Complications; Drug dosages; Hospitals; Magnetic resonance imaging; Main Articles; Mastoiditis; Otitis media; Otolaryngology; Patients; Staphylococcus infections; Streptococcus infections; Surgery; Thrombosis; United Kingdom > UK; England; Radiology; Anti-Bacterial Agents; Mastoiditis; Suppuration; Mastoidectomy
• ISSN: 0022-2151; 1748-5460
• DOI: 10.1017/S0022215120000833

Mastoiditis is the most common intra-temporal complication of acute otitis media. Despite potentially lethal sequelae, optimal management remains poorly defined. A retrospective case review was conducted of children diagnosed with mastoiditis at a tertiary referral centre, in North East England, between 2010 and 2017. Fifty-one cases were identified, 49 without cholesteatoma. Median patient age was 42 months (2 months to 18 years) and median hospital stay was 4 days (range, 0-27 days). There was no incidence trend over time. Imaging was conducted in 15 out of 49 cases. Surgery was performed in 29 out of 49 cases, most commonly mastoidectomy with (9 out of 29) or without (9 out of 29) grommets. Complications included sigmoid sinus thrombosis (3 out of 49) and extradural abscess (2 out of 51), amongst others; no fatalities occurred. A detailed contemporary description of paediatric mastoiditis presentation and management is presented. The findings broadly mirror those published by other UK centres, but suggest a higher rate of identified disease complications and surgical interventions.