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Mastoid subperiosteal abscess in children: drainage or mastoidectomy?

Published online by Cambridge University Press:  26 October 2012

I Psarommatis*
Affiliation:
ENT Department, ‘P & A Kyriakou’ Children's Hospital of Athens, Greece
P Giannakopoulos
Affiliation:
ENT Department, ‘P & A Kyriakou’ Children's Hospital of Athens, Greece
E Theodorou
Affiliation:
ENT Department, ‘P & A Kyriakou’ Children's Hospital of Athens, Greece
C Voudouris
Affiliation:
ENT Department, ‘P & A Kyriakou’ Children's Hospital of Athens, Greece
C Carabinos
Affiliation:
ENT Department, ‘P & A Kyriakou’ Children's Hospital of Athens, Greece
M Tsakanikos
Affiliation:
ENT Department, ‘P & A Kyriakou’ Children's Hospital of Athens, Greece
*
Address for correspondence: Dr Ioannis Psarommatis, ENT Department, ‘P & A Kyriakou’ Children's Hospital of Athens, Thivon & Levadias St, 11527 Goudi, Athens, Greece E-mail: [email protected]

Abstract

Objective:

To evaluate the management of mastoid subperiosteal abscess using two different surgical approaches: simple mastoidectomy and abscess drainage.

Method:

The medical records of 34 children suffering from acute mastoiditis with subperiosteal abscess were retrospectively reviewed. In these cases, the initial surgical approach consisted of either myringotomy plus simple mastoidectomy or myringotomy plus abscess drainage.

Results:

Thirteen children were managed with simple mastoidectomy and 21 children were initially managed with abscess drainage. Of the second group, 12 children were cured without further treatment while 9 eventually required mastoidectomy. None of the children developed complications during hospitalisation, or long-term sequelae.

Conclusion:

Simple mastoidectomy remains the most effective procedure for the management of mastoid subperiosteal abscess. Drainage of the abscess represents a simple and risk-free, but not always curative, option. It can be safely used as an initial, conservative approach in association with myringotomy and sufficient antibiotic coverage, with simple mastoidectomy reserved for non-responding cases.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2012

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Footnotes

Presented in part (2002–2009 data) at the 10th International Congress of the European Society of Pediatric Otorhinolaryngology, 5–8 June 2010, Pamplona, Spain

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