Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-27T23:12:48.908Z Has data issue: false hasContentIssue false
  • English
  • Français

Acute mastoiditis in children: contemporary opportunities and challenges

Published online by Cambridge University Press:  28 May 2020

M Mather ,
S Powell ,
P D Yates  and
J Powell
M Mather*
Affiliation:
Department of Otolaryngology, Great North Children's Hospital, Newcastle upon Tyne, UK
S Powell
Affiliation:
Department of Otolaryngology, Great North Children's Hospital, Newcastle upon Tyne, UK
P D Yates
Affiliation:
Department of Otolaryngology, Great North Children's Hospital, Newcastle upon Tyne, UK
J Powell
Affiliation:
Department of Otolaryngology, Great North Children's Hospital, Newcastle upon Tyne, UK
*
Author for correspondence: Mr M W Mather, Institute of Cellular Medicine, 3rd Floor Leech Building, Framlington Place, Newcastle University, Newcastle upon TyneNE2 4HH, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Mastoiditis is the most common intra-temporal complication of acute otitis media. Despite potentially lethal sequelae, optimal management remains poorly defined.

Method

A retrospective case review was conducted of children diagnosed with mastoiditis at a tertiary referral centre, in North East England, between 2010 and 2017.

Results

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.

Conclusion

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.

Keywords

MastoiditisSuppurationMastoidectomyAnti-Bacterial AgentsRadiology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 5 , May 2020 , pp. 434 - 439
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Mr M W Mather takes responsibility for the integrity of the content of the paper

Results presented at 14th Congress of the European Society of Pediatric Otorhinolaryngology (ESPO), 2–5 June 2018, Stockholm, Sweden.

References

Mattos, JL, Colman, KL, Casselbrant, ML, Chi, DH. Intratemporal and intracranial complications of acute otitis media in a pediatric population. Int J Pediatr Otorhinolaryngol 2014;78:2161–4CrossRefGoogle Scholar
Thompson, PL, Gilbert, RE, Long, PF, Saxena, S, Sharland, M, Wong, IC. Effect of antibiotics for otitis media on mastoiditis in children: a retrospective cohort study using the United Kingdom General Practice Research Database. Pediatrics 2009;123:424–30CrossRefGoogle ScholarPubMed
Kullar, P, Yates, PD. Infections and foreign bodies in ENT. Surgery 2012;30:590–6Google ScholarPubMed
Psarommatis, IM, Voudouris, C, Douros, K, Giannakopoulos, P, Bairamis, T, Carabinos, C. Algorithmic management of pediatric acute mastoiditis. Int J Pediatr Otorhinolaryngol 2012;76:791–6CrossRefGoogle ScholarPubMed
Quesnel, S, Nguyen, M, Pierrot, S, Contencin, P, Manach, Y, Couloigner, V. Acute mastoiditis in children: a retrospective study of 188 patients. Int J Pediatr Otorhinolaryngol 2010;74:1388–92CrossRefGoogle ScholarPubMed
The Newcastle upon Tyne Hospitals NHS Foundation Trust Annual Report & Accounts 2016/17. In: http://www.newcastle-hospitals.org.uk/downloads/About%20us%20pages/NEWCASTLE_FT_Annual_Report_2016-17_lo-res_-_FINAL.pdf [24 March 2020]Google Scholar
Attlmayr, B, Zaman, S, Scott, J, Derbyshire, SG, Clarke, RW, De, S. Paediatric acute mastoiditis, then and now: is it more of a problem now? J Laryngol Otol 2015;129:955–9CrossRefGoogle ScholarPubMed
Luntz, M, Brodsky, A, Nusem, S, Kronenberg, J, Keren, G, Migirov, L et al. Acute mastoiditis – the antibiotic era: a multicenter study. Int J Pediatr Otorhinolaryngol 2001;57:1–9CrossRefGoogle ScholarPubMed
Palma, S, Fiumana, E, Borgonzoni, M, Bovo, R, Rosignoli, M, Martini, A. Acute mastoiditis in children: the “Ferrara” experience. Int J Pediatr Otorhinolaryngol 2007;71:1663–9CrossRefGoogle ScholarPubMed
Groth, A, Enoksson, F, Hermansson, A, Hultcrantz, M, Stalfors, J, Stenfeldt, K. Acute mastoiditis in children in Sweden 1993–2007--no increase after new guidelines. Int J Pediatr Otorhinolaryngol 2011;75:1496–501CrossRefGoogle ScholarPubMed
Laulajainen-Hongisto, A, Saat, R, Lempinen, L, Markkola, A, Aarnisalo, AA, Jero, J. Bacteriology in relation to clinical findings and treatment of acute mastoiditis in children. Int J Pediatr Otorhinolaryngol 2014;78:2072–8CrossRefGoogle ScholarPubMed
Brenner, DJ, Hall, EJ. Computed tomography – an increasing source of radiation exposure. N Engl J Med 2007;357:2277–84CrossRefGoogle ScholarPubMed
Pearce, MS, Salotti, JA, Little, MP, McHugh, K, Lee, C, Kim, KP et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet 2012;380:499–505CrossRefGoogle ScholarPubMed
Morton, RP, Reynolds, RM, Ramakrishna, R, Levitt, MR, Hopper, RA, Lee, A et al. Low-dose head computed tomography in children: a single institutional experience in pediatric radiation risk reduction. J Neurosurg Pediatr 2013;12:406–10CrossRefGoogle ScholarPubMed
Stutzki, M, Jahns, E, Mandapathil, MM, Diogo, I, Werner, JA, Güldner, C. Indications of cone beam CT in head and neck imaging. Acta Otolaryngol 2015;135:1337–43CrossRefGoogle ScholarPubMed
Fan, X, Xia, M, Wang, Z, Zhang, H, Liu, C, Wang, N et al. Comparison of electrode position between round window and cochleostomy inserting approaches among young children: a cone-beam computed tomography study. Acta Otolaryngol 2018;138:815–21CrossRefGoogle ScholarPubMed
Anthonsen, K, Høstmark, K, Hansen, S, Andreasen, K, Juhlin, J, Homøe, P et al. Acute mastoiditis in children. Pediatr Infect Dis J 2013;32:436–40CrossRefGoogle ScholarPubMed
Niv, A, Nash, M, Slovik, Y, Fliss, DM, Kaplan, D, Leibovitz, E et al. Acute mastoiditis in infancy: the “Soroka” experience: 1990–2000. Int J Pediatr Otorhinolaryngol 2004;68:1435–9CrossRefGoogle ScholarPubMed
Croche Santander, B, Porras González, A, Obando Santaella, I. Acute mastoiditis: experience in a tertiary-care center in the South of Spain during 1999–2008 period. [in Spanish]. An Pediatr (Barc) 2010;72:257–62CrossRefGoogle Scholar
Butbul-Aviel, Y, Miron, D, Halevy, R, Koren, A, Sakran, W. Acute mastoiditis in children: Pseudomonas aeruginosa as a leading pathogen. Int J Pediatr Otorhinolaryngol 2003;67:277–81CrossRefGoogle ScholarPubMed
Obringer, E, Chen, JL. Acute mastoiditis caused by Streptococcus pneumoniae. Pediatr Ann 2016;45:e176–9CrossRefGoogle ScholarPubMed
Mather, M, Musgrave, K, Dawe, N. Is anticoagulation beneficial in acute mastoiditis complicated by sigmoid sinus thrombosis? Laryngoscope 2018;128:2435–6CrossRefGoogle ScholarPubMed
Loh, R, Phua, M, Shaw, CL. Management of paediatric acute mastoiditis: systematic review. J Laryngol Otol 2018;132:96–104CrossRefGoogle ScholarPubMed